What to do in Menstrual Cycle Related Migraine?

Some women may complain of getting headache (may be migraine headache) in relation to menstrual cycle. Management or treatment of these type of migraine in women may be difficult and commonly used drugs for migraine (like NSAIDs, analgesics) may not work in these women, even for mild to moderate migraine headaches where generally NSAIDs and analgesics works well for others. The menstrual cycle related headache (migraine) may be occur during menstrual cycle or just before menstrual cycle starts.

The migraine headache that occurs in relation to menstrual cycles can be managed in two ways, the first and preferred way is to give preventive treatment and the other option is to treat the symptoms as and when the symptoms of migraine headache appear.

The prevention or preventive treatment:

The best way to manage a woman with menstrual cycle related migraine is to manage with preventive measures. It is always better to prevent than to cure. The prevention of menstrual cycle related migraine headache is done by administering ergotamine (at the dose of 2 mg per dose) tablet orally at night time before going to bed. Another option for preventive treatment is to use estrogen patches. The main point to remember is that the drugs to be used few days before the start of the migraine headache. They should not be started after attacks of migraine. The woman usually knows when (it may be few days before starting of menstruation or during menstruation, but the patient knows when she gets the attacks of migraine) she is going to get the migraine attack from her experience.

Management of migraine after attacks:

The management of migraine attacks related to menstrual cycle is usually done with dihydroergotamine nasal spray or with triptans. Any of the available triptans can be used as their efficacy is approximately the same (for all the triptans). The efficacy of these drugs in managing the menstrual cycle related migraine is same as for other types of migraine headaches.