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Hormone Testing and Hormone Management is Important for Curing Menstrual Migraine

Migraines are very estrogen sensitive.

The estrogen excursions that trigger a migraine can be due to perimenopause, menopause, a menstrual cycle, pregnancy, or post partum estrogen changes. But a true menstrual migraine occurs during a menstrual period.

Migraines should be diagnosed by a health care provider, and once diagnosed, have a discussion as to whether your cure could mean managing hormonal health.

Migraine sufferers have headaches, but often they will have associated physical warning symptoms as well. Some of the warning symptoms are vague and some are more typically recognized as migraines. These may be nausea, light adversity, odd sense of smell or even vomiting. These non-headache neurological symptoms that occur when the pain starts are known as auras. Recent studies have shown that it is actually more common to have migraines without warning than with warning auras.

Either type of migraine, with or without aura could be due to estrogen changes, and these changes can be so variable women might have migraine symptoms that precede the actual headache pain by a day or even several days. Other neurological symptoms may be those that are commonly recognized to be associated with migraines: like spots before your eyes, vision changes or, fatigue.

Migraine headaches can persist into menopause, although some women do see relief of their headaches once they completely transition through perimenopause, and get a few years beyond menopause.

Menstrual migraines are often listed under migraine myths, but they do occur. Menstrual migraines do exist and are not a myth. The good news is these typically resolve with menopause.

The IHS has given us a definition of menstrual migraine, and for those wanting to get more in depth with their migraine analysis can go to their headache classification system which is very useful. Menstrual migraines occur two days before to 3 days after the onset of bleeding and at no other times during the cycle. To have this condition you should be having your menstrual cycle migraines almost each time you have your period: but officially if you have them 2 of 3 periods you have the disease. Women generally feel that these are triggered by the hormonal shifts that do occur at this time of the month as they can experience other signs of the hormonal withdrawal. There is a known drop in estrogen right before the period, and it takes a few days for those levels to rise significantly, so perhaps it’s this low estrogen that is bringing on the migraine. It’s possible in menopause to adjust the estrogen level with hormone replacement therapy to the level that is optimal for a particular woman, thus decreasing migraine headaches. You have to weigh this against any other risks of headaches, and it still might be something to try for those still seeking relief, come in to discuss with your gyno at Women’s Health Practice.

The data from the Women’s Health Initiative to assess the risk/benefit profile of reproductive hormone therapy in menopausal women with migraine. They showed women with hot flashes were more likely to be migraine sufferers. It is also thought that migraine treatment can possibly have secondary benefit in teasing of some hot flashes and that symptomatic women with migraines can benefit from hormone replacement therapy and see fewer migraines.

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Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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