Symptoms
Menstrual migraine is a migraine without aura that typically occurs 2 days before to the 3rd day of menstruation Two forms are distinguished, first, menstrual migraine that occurs exclusively on these days and second, migraine that also, but not exclusively, occurs on these days.
Causes
The causes are not yet fully understood. Estrogen withdrawal is primarily discussed as the cause. This also occurs in the normal mode of taking oral contraceptives. Prostaglandin release also probably plays a role cf. dysmenorrhea.
Diagnosis
With a headache diary taking into account the cycle over 2-3 months.
Drug treatment
With migraine medications as for other forms of migraine. Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen may be more effective than acetaminophen because they inhibit prostaglandin synthesis. Drug prophylaxis (empiric options):
- NSAIDs – are analgesic and inhibit prostaglandin synthesis.
- Estrogens – substitute the estrogen deficit.
- Triptans – are vasoconstrictor
- Taking oral contraceptives without breaks – against the estrogen deficit.
