menstrually related migraine

26 October 2009

A Review of Menstrual Migraine (the book)

I liked this book. You probably wouldn’t, but I sure did.

All right, let me qualify that a little bit. The book I’m talking about is the brand new Menstrual Migraine, edited by Dr Susan Hutchinson and Dr B. Lee Peterlin. And you may like it after all – if you’re a health professional, like a doctor or nurse. That’s really the target of the book. But let me give you a bit of an overview.

Actually, the back of the book gives a very good summary:

Tailored to the needs of busy health-care professionals treating female patients in the primary care setting, the book focuses on essential clinical information for physicians, nurse practitioners, and assistants in family practice, internal medicine and OB/GYN.

Using some of the statistics in this book, it’s quite possible that 10% of women have migraine related to their menstrual cycles. That’s not 10% of women with migraine, that’s 10% of the general population! So as a health professional, you can see why it would be important to have the best information about something that impacts 1 in 10 of the women you see. Of course, it will probably be more than 1 in 10, because those with menstrual migraine will, I hope, be more likely to see their doctor.

And this book is exactly that – the latest, cutting edge information about migraine and specifically menstrual migraine, in a small package. The book is only 95 pages including indexes. It’s actually a series of write-ups by various experts on related topics, such as:

Hormonal therapy and menstrual migraine
Tips and pearls for the diagnosis of migraine and menstrually related migraine
Pharmacotherapy
Nonpharmacological interventions for the management of menstrually related migraine

Though of course even the experts don’t always agree with one another, I was very impressed that this was really cutting-edge information. Published only last year, Menstrual Migraine has brought together the latest in research so that you can get a quick overview of where the science is and where it’s going, and how it relates to treatment in a practical way.

You can already see from the titles above, the book doesn’t make an attempt to be accessible to the layperson. There’s a lot of technical language, scientific charts and numbers, and terms and short hand that most people will have trouble following without some medical background. But the book is very well organized for those who will make the best use of it.

With so many out-dated or poorly researched works out there, this one was a relief to read. I know I will keep it handy and will be using it as a reference frequently (in fact I’ve already found myself reaching for it to check on various things).

Menstrual Migraine also includes some handy appendices, with further resources, questionnaires for use with patients, and headache diaries.

Menstrual Migraine, a part of the Oxford American Pain Library, is a small handbook that provides practical, up-to-date information on a widespread issue. It would be of value to every doctor and health professional that have female patients, and certain other people who want to see essential aspects of the latest research.

Note: What’s with all the reviews!? In case you’re wondering, I made it a project to collect some books over the summer to review. Of course, I had no time over the summer to actually review them, so I’m catching up over the fall! That’s the reason for the sudden influx of reviews. I hope you’ll find the resources helpful. I’ll probably just have one more book review in the near future, and then things will slow down for a while. 🙂

6 April 2009

When Menstrually Related Migraine isn’t Alone

James Discoveries & Stats, Treatments 4

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.

9 February 2008

Frova now an option in Canada

James Medications 1

Last month a new option was made available to people with migraine in Canada. That option is another triptan drug – frovatriptan succinate, to be exact, or Frova.

Frova has had its ups and downs. It has showed some promise particularly for menstrually related migraine. It was heavily promoted (in a round about way) for menstrual migraine, and so it was quite a blow when, late last year, the American FDA refused to allow it to be labelled as a short term prevention for menstrual migraine.

Still, I take it as a good sign that it’s available in Canada. In that category of drugs you take when a migraine is coming on (abortives), the triptan drugs have been very helpful. Not only can they help with headache, they can help with symptoms like nausea. And not every triptan is helpful for everyone – so the more options available, the better. If you’ve tried one triptan and haven’t found relief, it’s worth it to try something else.

For more, read the press release about Frova in Canada here.

6 June 2005

Menstrually-Related Migraines trial

James News 0

They’re a huge problem – menstrual migraines. You’ve probably heard about tennis pro Serena Williams, who is doing the rounds promoting Endo Pharmaceuticals’ Frova (frovatriptan) for menstrually related migraines (MRM). Frova is yet another triptan that does work well…for some people. But new treatments are needed for those who still aren’t finding relief.

A new study is being done, and if you live in the USA or Canada you can be a part of it. You need to be 15 years old or older, you must be diagnosed with MRM, and you must have had at least two MRM attacks in the last three months. To find out if you qualify to try this new oral treatment, just call [trial has ended]. You could be part of a new treatment for many women out there.