Paper
Migraine Management During Menstruation and Menopause
Published Aug 1, 2015 · E. MacGregor
CONTINUUM: Lifelong Learning in Neurology
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Abstract
Purpose of Review:Migraine is most prevalent in women during their reproductive years. An understanding of the effects of menstruation and menopause on migraine can enable neurologists to provide targeted and appropriate medical and hormonal strategies, enabling their patients to achieve better control of migraine and reduced disability. This article reviews the effects of hormonal events on migraine and summarizes the evidence-based options available for management. Recent Findings:Estrogen “withdrawal” during the late luteal phase of the natural menstrual cycle and the hormone-free interval of combined hormonal contraceptives has long been implicated in the pathophysiology of menstrual migraine. However, more recent research suggests that other independent mechanisms may be relevant. Prostaglandin inhibitors used for management of dysmenorrhea are effective for associated menstrual migraine, suggesting a common pathophysiology. The interplay between serotonin and estrogen also deserves further research. Summary:Menstrual and perimenopausal migraine can be managed effectively using a variety of strategies, the choice of which depends on the efficacy of acute treatment, predictability and regularity of menstruation, use of contraception, and presence of menstrual disorders or perimenopausal vasomotor symptoms.
Menstrual and perimenopausal migraine can be effectively managed using a variety of strategies, depending on acute treatment efficacy, menstruation predictability, contraception use, and presence of menstrual disorders or perimenopausal vasomotor symptoms.
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