Menstrual Migraine and Its Treatment

Abstract

Migraine often begins during menarche and generally improves during the second and third trimesters of pregnancy. According to epidemiologic studies, up to 60% of migraines are menstrual migraine. A new subclassification for menstrual migraine was proposed in the 2004 International Classification of Headache Disorders that differentiated between pure menstrual migraine without aura and menstrually-related migraine without aura. The decline in the estrogen level occurring before menstruation has been implicated as the precipitating biologic event for menstrual migraine. Menstrual migraine are of longer duration and are more likely to be severe than headaches occurring at the other times in the menstrual cycle. The options available for the treatment of menstrual migraine include nonpharmacologic approaches, acute therapy, short-term preventive therapy and long-term preventive therapy. The purpose of the present study is to assess the diagnosis, pathogenesis and treatment of menstrual migraine.