About 15 % of women are known migraine sufferers. For half of these, their migraines happen in the few days before or after their period ? usually in the week either side of it. Some also get migraines in the middle of their cycle when they are ovulating.
How does the menstrual cycle work?
The cycle is controlled by hormones secreted by the ovaries in the reproductive system and the pituitary gland in the brain. The average cycle is 28 days. After a woman?s period is finished, the levels of estrogen rise to help the lining of the womb to thicken up ? it?s getting ready for an egg to implant and grow.
In the middle of the cycle, the ovaries release an egg. This is called ovulation. If the egg isn?t fertilized by a sperm and implanted, the progesterone levels fall and the lining of the womb comes away. This is called a period or menstruating. The cycle then repeats.
It is thought that the fluctuations in the hormone levels are what may trigger a migraine ? not the actual levels themselves.
Dreading that time of the month
Many women dread their period coming as they know it may bring a migraine with it. Some people say that premenstrual migraines are worse than ?normal? ones. Part of the reason for this is that the woman is also dealing with the other symptoms of menstruation, such as:
- backache
- nausea
- tender breasts
- feeling bloated
- abdominal pain
- legs aching
- feeling more tired than usual
- feeling emotionally up and down.
A migraine on top of all that is extremely unpleasant.
Do premenstrual cravings bring on migraines?
When a period is due, many women experience intense food cravings. These often include chocolate, which is thought to be a migraine trigger.
What help is there for premenstrual migraines?
Three main areas need looking at to help with and improve migraines:
- Changes in diet: limit caffeine, avoid known triggers, eat regularly to prevent sugar levels dropping.
- Medications: painkillers, anti-sickness drugs and drugs that can work on the blood vessels can all help with a migraine
- Checking out possible underlying causes: stress, high blood pressure.
Another possible treatment is to try and prevent the migraines by preventing the period. Taking the combined contraceptive pill without a break for three cycles is recommended. Migraines can occur in the pill-free week but this mainly happens with contraceptive pills containing a high level of progestogen. Taking a pill with higher levels of estrogen can help.
This can reduce the migraine ?windows of opportunity? to 5 weeks a year instead of 13.
Another treatment is estrogen patches or cream. For more information on either of these, consult with your doctor.
Please note that migraine treatments or contraceptive pills containing estrogen are not suitable for women who have suffered an estrogen positive breast cancer. (These women are likely to be on tamoxifen for five years following their cancer treatment.)
Remember, if in any doubt, see your doctor.
