true menstrual migraine

Menstrual Migraine is usually split into two categories.  First, True Menstrual Migraine which, at least 90% of the time, hits during your period.  Second, Menstrually Related Migraine (MRM), which can occur other times of the month, but do seem to be related to hormonal changes.

Obviously the second category is a lot more vague.  Are all the attacks you’re getting really related to hormonal changes?  Most often, the answer is probably no.  Many attacks may be triggered by other things, and so it’s hard to know where to start when it comes to fighting migraine attacks.

One common way to treat menstrually-related migraine is to use hormonal therapy.  That might include extended-cycle oral contraceptives, or more often some form of estrogen supplement (this is a simplification – these are sometimes complex treatments of many different varieties).  The problem is, there’s no evidence that these treatments will help eliminate migraine attacks that aren’t menstrually related.

A 2008 study from the Department of Neurology at the University of North Carolina set out to discover if treating MRM with hormonal therapy would also cut back on other attacks.  They were concerned about chronic migraine and medication overuse headache.

Their study of 229 women found that generally there was a good response to hormonal therapy.  Also, a large percentage got over the chronic migraine attacks, and were able to get out of the cycle of medication overuse.

It makes sense that cutting back on even some migraine attacks would help with cutting back medication in general.  But it’s even more encouraging that the chronic pattern could be broken, though we’re still not talking about everyone here (59% of women who were helped by the hormonal treatment also went from chronic migraine attacks to episodic – less frequent).

Still, it may be that hormonal treatments have a wider benefit than was previously believed.

Read more in the study entitled Elimination of menstrual-related migraine beneficially impacts chronification and medication overuse.  Also, read this summary of menstrual migraine.