When Menstrually Related Migraine isn’t Alone
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.
6 April 2009 @ 2:03 pm
I suffer from chronic migraines, and i also suffer from borderline personality disorder, bipolar disorder, and pmdd, and ptsd. I have a really tough time trying to find medications that work to knock my migraines out. I am taking propanalol and topomax every day as a preventitive. I am having a lot of trouble with my migraines right now. I have an appt with the headache clinic to get seen. Wish me luck!
10 April 2009 @ 6:24 am
It does make things complicated when migraine isn’t alone – and it almost never is, it seems!
2 June 2009 @ 12:53 am
I have developed myalgia and I feel just like I do right after a migraine all the time. I am getting the migraines every day now, sometimes 2x a day. The migraines are different from the ones I have been used to having. They are more located at my right eye. I saw a rheumatologist and he said I have chronic myalgia and that he cannot determine where it came from nor what it orignitated from. I am at a loss as to what to do. I am having horrible muscle and joint pain along with migraines and severe depression. I would like to know if it is possible that the myalgia came from my migraines being so bad for so long and going on for so long. I treat them but the treatment does not always work. I suffer for days in pain from the migraine and myalgia. I would like to hear suggestions as to where to go from here. I see my neurologist on June 9. I take currently 200 mg of topomax, 20 mg of imitrex 2x a day as needed, propanalol, 120 mg of celexa for the migraines and myalgia right now.
27 February 2013 @ 12:20 pm
Gwen I also have ME and my migraines are linked closely now although a change in hormones (pregnancy) triggered mine.
Ametriptylin is the best for me and would prob work for both of your conditions.
Although I now don’t take as a preventative I take 40mg or 50 when I need to sleep with migraines and it solves that. I wake up feeling loads better.