period headaches: women & menstrual migraines
Menstrual migraine (also known as a period headache) treatment should begin with non-prescription medications, and non-steroidal anti-inflammatories in particular. Many women find that these medications relieve headache pain as well as other menstrual symptoms. When basic over the counter medications don't yield results, the patient should graduate to extra strength aspirin or acetaminophen with caffeine.
Some women have had success staving off migraines by taking over the counter medications as a preventative measure before their menstrual cycle. For women on birth control it is recommended that they begin any non-steroidal anti-inflammatory medicine treatment after the nineteenth day of their period and stop on the second day of their next cycle. The limited duration of menstrual migraines makes them less likely to lead to medication overuse headaches or rebound headaches or gastrointestinal symptoms. If non-prescription methods are not having the desired affect, prescription medications are the next course of action.
Some of the most effective medicines against menstrual migraines are the anticonvulsant, verapamil, the beta blocker, propranalol, and the calcium channel blocker, verapamil. They should be started two days before the menstrual cycle or as soon as it starts when the cycle is less regular. Onset abortive medicines that act like serotonin receptor agonists can be an effective treatment for menstrual headaches. Ergotamine medicines have declined in popularity with the increased use of Triptan which attacks serotonin receptors but without other medicines' symptom profiles. Unfortunately, Triptan is more expensive than other medications, even non-generic drugs, and even when covered on an insurance prescription plan.
Anti-depressants can be used to treat menstrual migraines because of their affect on serotonin receptor signals. Particularly effective are selective serotonin reuptake inhibitors (SSRI). Any patient taking an anti-depressant for an off label use, like headache relief, will benefit from doctor reassurance that the drug's use is not indicative of mental illness. Awareness of biochemical foundations of the nervous system should be encouraged, especially in relation to those mistakenly thought to be character attributes.
At New Jersey Headache Institute, our doctors and staff have extensive experience treatments for headaches in women, including menstrual migraines. Call us today for an appointment.