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Frequently asked questions about Menstrual Migraine

Q: What is a migraine?
A: A migraine is a common, recurrent, disabling headache disorder that can last from 4 to 72 hours.1 There are a number of characteristics that are typical of a migraine.1 These characteristics include moderate-to-severe pain on one side of the head that may throb. Exertion during routine physical activities—such as walking or climbing stairs—can make it worse. Migraines are often accompanied by nausea, vomiting, and a sensitivity to light and sound.

Some migraines may come with visual disturbances known as aura.1 Menstrual Migraine is typically without aura.1 Characteristics of an aura may include flickering lights, spots, or lines that appear before the eyes, or loss of vision in some cases.1 Many people lie down in a darkened room to help alleviate their migraine.2 While migraines are not life threatening, they can cause major disruptions to your personal and professional life.

Q: What causes a migraine?
A: Migraines are caused by a chemical imbalance in the brain that causes the blood vessels in your head to expand, resulting in pain.3 Some common triggers that can help bring on a migraine include alcohol (especially beer and red wine), too much caffeine, stress, bright lights/sun glare, eyestrain, changes in the weather, foods such as chocolate, aged cheese, nuts, cured meats, onions, and food additives such as MSG, aspartame, and nitrates.4,5,6 In addition to these triggers, changes in hormone levels may play a role in migraine attacks associated with a woman’s period, often referred to as Menstrual Migraine.7,8

Q: What is Menstrual Migraine?
A: There are actually two types of Menstrual Migraines—Menstrually Related Migraine (MRM) and Pure Menstrual Migraine (PMM). A Menstrually Related Migraine is a headache of moderate-to-severe pain intensity that happens during a certain window of time around the period and at other times of the month as well.1 A Pure Menstrual Migraine is similar in every respect, but occurs during the time around your period.1

Q: What causes Menstrual Migraine?
A: The exact causes of Menstrual Migraine are uncertain, but there seems to be a connection between changes in hormone levels around menstruation and migraine. Studies have suggested that it may have something to do with changes in hormone levels, which normally occur right before the period starts.7,8 In those women who are likely to suffer from migraine, this can act as a hormonal trigger.7,8

Q: How common is Menstrual Migraine?
A: Approximately 21 million women in the United States suffer from migraines,9 and about 60% of them suffer from Menstrually Related and Pure Menstrual Migraines combined.10,11

Q: Are there distinguishing features between Menstrual Migraines and migraines that occur at other times?
A: Yes, there are. Menstrual Migraines have been reported as more severe than other migraines, may persist longer, and may occur more frequently.12-15


References:
  1. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders. 2nd ed. Cephalalgia. 2004;24(suppl 1):24-36; 138-149. Available at: http://216.25.100.131/ihscommon/guidelines/pdfs/ihc_II_main_no_print.pdf. Accessed January 19, 2007.
  2. Mayo Clinic. Headaches: Treatment depends on your symptoms. Available at: http://www.mayoclinic.com/health/headaches/HE00001. Accessed November 19, 2007
  3. National Headache Foundation. Serotonin. Available at: http://www.headaches.org/consumer/topicsheets/serotonin.html. Accessed February 21, 2007.
  4. American Council for Headache Education. Headache Hygiene--What is it? Available at: http://www.achenet.org/education/patients/HeadacheHygiene.asp. Accessed November 19, 2007.
  5. American Council for Headache Education. Trigger Avoidance Information. Available at: http://www.achenet.org/tools/TriggerAvoidanceInformation.asp Accessed November 19, 2007.
  6. Mayo Clinic. Migraine: Causes. Available at: http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION=3. Accessed November 19, 2007.
  7. Lichten EM, Lichten JB, Whitty A, Pieper D. The confirmation of a biochemical marker for women’s hormonal migraine: the Depo-Estradiol challenge test. Headache. 1996;36:367-371.
  8. MacGregor EA. Oestrogen and attacks of migraine with and without aura. Lancet Neurol. 2004;3:354-361.
  9. Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41:646-657.
  10. Granella F, Sances G, Zanferrari C, Costa A, Martignoni E, Manzoni GC. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33:385-389.
  11. Dzoljic E, Sipetic S, Vlajinac H, et al. Prevalence of menstrually related migraine and nonmigraine primary headache in female students of Belgrade University. Headache. 2002;42:185-193.
  12. Granella F, Sances G, Allais G, et al. Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centres. Cephalalgia. 2004;24:707-716.
  13. Couturier EGM, Bomhof MAM, Knuistingh Neven A, van Duijn NP. Menstrual migraine in a representative Dutch population sample: prevalence, disability and treatment. Cephalalgia. 2003;23:302-308.
  14. MacGregor EA, Hackshaw A. Prevalence of migraine on each day of the natural menstrual cycle. Neurology. 2004;63:351-353.
  15. Martin VT, Wernke S, Mandell K, et al. Defining the relationship between ovarian hormones and migraine headache. Headache. 2005;45:1190-1201.

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