Menstrual Headaches

Menstrual headaches usually occur before, during or after menstrual cycle or at the time of ovulation. Studies show that about 60% of women suffer from menstrual headaches and out of which nearly 10 per cent experience severe headaches or migraines during their monthly cycle only. Basically menstrual related migraines (MRM) are of two types: premenstrual migraines and menstrual migraines. Premenstrual migraines generally occur between one to seven days i.e., a week before menstruation starts whereas menstrual migraines take place from the last day before your period begins and continues up to four days after bleeding starts.

Causes

Menstrual headaches are believed to be caused by changing estrogen levels in the body. Prior to menstruation, estrogen and progesterone levels fall instantly especially in women in their late thirties and forties. This decline in the hormonal levels act as a trigger for menstrual headaches. Also decline in estrogen levels can also cause mid-cycle headaches when the surge of estrogen related to ovulation occurs, and the instant drop in estrogen levels following this surge can trigger a migraine.

Birth control pills as well as hormone replacement therapy during menopause are some other contributing factors for migraine in women. In fact, research shows menstrual headaches are more severe in women taking birth control pills containing high doses of estrogen. Also migraines are less commonly seen in women taking oral contraceptives having lower doses of estrogen or containing progesterone. Besides these, malfunction of platelets, low levels of magnesium and endorphins are some other causes.

Symptoms

Generally symptoms are similar to migraine without aura. It begins as a one sided and gradually increases in severity, accompanied with other symptoms as given below:

• Nausea
• Vomiting
• Double vision
• Dizziness and weakness
• Mood swings
• Sensitivity to bright lights and sounds
• Ringing in ears or hearing loss
• Loss of balance

Treatment

Medications usually given to treat menstrual headaches are non steroidal anti-inflammatory medications (NSAIDs), including Orudis, Advil and Motrin, Nalfon, Naprosyn and Relafen. One can start taking these medications two to three days before the menstruation starts and continue it until the period ends. Women who want to continue taking birth control pills or have severe headaches are recommended to start taking these medications from the 19th day of the cycle and continuing through the second day of the next cycle.

Small doses of ergotamine drugs including Bellergal-S, Bafergot, Migranal, beta-blocker drugs like Propranolol, anticonvulsants like Valproate (Depakote) and calcium channel blockers such as Verapamil, can also be started two to three days prior menstruation, and continued throughout the cycle. But these medications should be consumed only under a doctor's recommendation. Also these medications are not recommended to treat migraine in pregnant women, as they can affect the uterus and hamper the baby growth. However, if these medications are not successful, one has to go for a hormonal therapy in which a supplemental estrogen is given to the patient perimenstrually either by mouth or in a transdermal patch. Estradiol (0.5 mg tablet twice a day, or 1 mg patch) is one of the recommended form of estrogen that can be given to the patient.

Dietary changes like incorporating foods that encourage estrogen production in the body like soy, apples, alfalfa, cherries, potatoes, rice, wheat and yams in your diet, limiting caffeine, eating regularly to maintain blood sugar levels, doing yoga and meditation, and some breathing exercises are consider to be some effective natural remedies. However, if the headache does not subside even after trying the aforementioned treatments, it is better to consult a doctor to elucidate the case.