Guest Author - Joyce N. Eldridge, M.Ed.

There are several types of migraine headaches. The assumption that a migraine is a migraine is just that, an assumption. At times, migraines can be unpredictable. Some people are able to identify their “triggers”—events or conditions known to cause migraines. For others, the headaches begin as randomly as they end. Being able to isolate and track even one type of migraine sets the stage for research to better identify and treat all classes of headaches. Since the woman’s menstrual cycle is relatively regular, this is an excellent opportunity for researchers to get reliable information that can aid in developing methods and medications to treat women with migraines.

Women suffer from migraine headaches three times more often than men. It is believed that the menstrual cycle has a great deal to do with this. Because 60-70% of female migraine sufferers experience migraines before, during or immediately after their monthly periods, a specific class of migraine headaches has been identified—Menstrual Migraines. During her period, a woman experiences a drop in the hormone estrogen. This drop is a major trigger for migraines because it causes changes to the serotonin levels in the brain. Serotonin is a chemical in the brain that affects the way we feel pain.

Within the scope of the menstrual migraine, researchers have identified two types—Menstrual Related Migraine (MRM) and Pure Menstrual Migraine (PMM). MRMs are moderate to severe headaches that occur at a specific time around the period every month and at other times of the month. In contrast, PMMs only occur during a specific time around the period and not at other times of the month. PMMs are believed to be caused solely by estrogen fluctuations. The PMM tends to be more painful, last longer, and is unrelieved by migraine medication.

Only a doctor or medical professional can assess headache symptoms and diagnose migraine headaches. For any woman who feels that she is suffering from either type of menstrual migraine, it is important to discuss the symptoms with her doctor. In order for a woman to be prepared to discuss her symptoms and work with her doctor to create an effective treatment plan, one of the first steps she should take is to start a journal to include such information as:

·The frequency, intensity and duration of the headaches
·Was there a specific “trigger” prior to the headache occurring?
·What symptoms were experienced? Nausea, vomiting, sensitivity to lights/sounds/smells? Others?
·Did medication relieve the migraine? If so what medication? Prescription or over-the-counter?
·What, if any, non-medical interventions worked to relieve the headache?

While journaling, the woman should also indicate the first day of her period for each month. It is helpful to do this for at least 3-6 months to identify which days she is more at risk of experiencing a migraine, and to get effective data to aid in treatment planning.

In addition to identifying external triggers such as foods, stressors and changes to the environment that may effect the onset of a menstrual migraine, another unique trigger that can only affect women is their use of birth control pills. Once menstrual migraines are diagnosed, medical professionals may suggest taking forms of birth control pills that allow the woman to go for several months at a time without her period. There are several new versions of this pill on the market. The idea behind this is that if the woman does not experience her period, she will not experience the hormonal drop that occurs during her period; therefore hormone and serotonin levels will remain steady and the migraine headache will not occur. For women suffering from Pure Menstrual Migraines, this idea may work better because they do not suffer from migraines at any other time of the month.

Overall, accurate diagnosis and treatment is key. A woman should never feel that migraines are just apart of being a woman. She should not have to suffer alone and in silence. There is hope. Doctors are now developing migraine specific treatment plans and prescribing medications to not only treat the migraine but prevent them all together. Now that would be exciting!