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PMS and Premenstrual Migraine

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In women, around 15 % suffer from migraine, with half of them having migraines before or after their period. There are also women who get migraines sometime during the middle of their menstrual cycle, while they ovulate.

The Menstrual Cycle

A woman's average menstrual cycle lasts for about 28 days, and is mainly controlled by the hormones secreted by the ovaries in the reproductive system and by the pituitary gland in the brain.

After the period is over, the estrogen levels increase in order to thicken up the womb's lining in preparation for egg to implant and grow. The ovaries release the egg in the middle of the menstrual cycle, and this process is known as ovulation. During this time, if a sperm does not fertilize the egg, the progesterone levels drop, causing the lining of the womb to fall away. This process is known as menstruation. After menstruation, the cycle repeats all over again.

It's believed that migraines are triggered by the fluctuations in the hormone levels, and not the actual hormone levels themselves.
Period Problems

Lots of women always dread the coming of their period, as they know all the problems that come with it, particularly a migraine. It is said that premenstrual migraines are worse than "normal" migraines, and this could be due to the other symptoms of menstruation that women have to deal with, like backaches, nausea, tender breasts, bloated feeling, abdominal pains, aching legs, exhaustion and mood swings. Getting a migraine along with all these symptoms can be an extremely unpleasant experience.

Premenstrual Cravings

Many women will have intense food cravings as their period approaches. Quite often these cravings will include chocolate, believed to trigger migraine.

Treatment for Premenstrual Migraine

To help treat migraines, three main areas need to be focused on:

  • Dietary Changes:  limiting intake of caffeine, avoiding known food triggers, eating regularly in order to prevent sugar levels from dropping.

  • Medications: drugs that work on the blood vessels can all help relieve a migraine, like painkillers and anti-sickness drugs.

  • Checking Possible Underlying Causes: other factors like stress and high blood pressure can cause premenstrual migraines.

Taking combined contraceptive pills is another method of treating premenstrual migraine. In this method, the migraines are prevented by preventing the period. It is recommended to take the pills without a break for three cycles. During the pill-free week, migraines can occur when the contraceptive pills taken contain a high level of progestogen, but this can be remedied by taking pills with higher levels of estrogen. This method can effectively cut the migraine ‘windows of opportunity’ from 13 weeks a year to just 5 weeks. Similar treatments would be to use estrogen patches or cream.

Migraine treatments or contraceptive pills with estrogen are not recommended for women who have been diagnosed with estrogen positive breast cancer. This is because they could have taken tamoxifen for five years following cancer treatment. As always, it is best to consult your doctor if you have doubts or need more information about these treatments.

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