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Remedies for Menstrual Migraines

Below is an article from Everyday Health Magazine interviewing several leading Physicians in the field of Migraine research. Click the link below for the direct article.

Hormonal changes in your menstrual cycle are one of the most common migraine triggers for women. If you suffer from menstrual migraines, read on for the 7 most effective treatments...

More than 70% of migraine sufferers are women. And more than half of them get these severe, debilitating headaches before or during their periods. That’s because estrogen levels drop sharply at that point in a woman’s menstrual cycle.

Although they can be painful and interfere with daily life, you can alleviate symptoms and lessen their intensity and frequency by taking medications and nutritional supplements and making lifestyle changes.

Read on for the top 7 menstrual migraine remedies.

Menstrual migraine treatment #1: Magnesium supplements About 50% of women who suffer from migraines have magnesium deficiencies, says neurologist Alexander Mauskop, MD, founder of the New York Headache Center, who conducted a series of studies on the subject in the late 1990s. He discovered that women taking magnesium supplements experienced significant relief.

*Magnesium helps relax blood vessels that constrict during a migraine attack.

For migraine prevention, doctors recommend a daily magnesium supplement dose of 400 mg. You can also eat more dark green vegetables, whole grains, beans, bananas and seafood.

Menstrual migraine treatment #2: Stress reduction Stress happens when you’re juggling job, family and other responsibilities. Unfortunately, it may also be one of your migraine triggers.

Adopting stress-reducing lifestyle changes can ease migraine symptoms, says Jennifer Milosavljevic, MD, an OB-GYN with Henry Ford Women’s Health Services in Detroit.

For example, migraine sufferers who quit smoking, decrease alcohol intake, establish a regular sleep schedule and exercise 3-4 times per week have fewer migraines, she says.

Meditation , deep breathing, biofeedback, yoga, and tia chi can also lessen menstrual migraines.

Several studies have found that aerobic exercise, in particular, may help manage migraines.

People with a history of migraines who participated in an aerobic exercise program had fewer migraines, or episodes that were briefer and less intense, a 2011 study by the Institute of Medical Psychology published in the International Journal of Sports Medicine found. The exercise group reported a 40% drop in the number of days they experienced migraines and a 43% drop in migraine intensity, compared with a control group that saw little change.

Besides reducing stress, exercise increases levels of endorphins, the body’s natural pain relievers. It may also improve circulation to the brain.

But first, warm up gradually, because sudden, vigorous exercise can precipitate or aggravate a migraine attack, doctors warn.

*And don’t exercise during a migraine because that can worsen symptoms.

Menstrual migraine treatment #3: Birth control pills Many women with irregular periods use hormonal birth control to regulate their cycles. For migraine sufferers, Dr. Milosavljevic recommends taking continuous birth control regimens, whether with birth control pills, the ring or a patch.

If you get menstrual migraines without aura – a neurological occurrence in which your vision is lost or blurred by flickering lights, spots or lines – taking birth control pills for pregnancy prevention can also improve migraine symptoms.

But don’t use them if your migraines are accompanied by aura, or if they get worse. If that happens, see a neurologist or a headache specialist

For these women, migraine attacks usually occur during the last week of their cycle. That’s because the last seven pills in most monthly pill packs don’t contain hormones; they’re there to help women stay in the habit of taking the pills every day. Without the hormones during that last week, drops in estrogen can trigger migraines in some women.

Menstrual migraine treatment #4: Avoid food triggers Steer clear of foods that can act as migraine triggers, Dr. Isaacs says. These vary from person to person, and may include chocolate, monosodium glutamate (MSG), processed meats with nitrates, dried fruits with sulfites, aged cheese, alcohol and red wine, and caffeine.

Eat meals at regular intervals too.

“Skipping breakfast can trigger a migraine,” Dr. Isaacs says.

Another tip: Keep a journal to track your diet and when you get symptoms. It will help you identify the foods that are migraine triggers for you.

Menstrual migraine treatment #5: Pain-relief meds Doctors often recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to treat migraines.

But beware of potential NSAID risks, such as increased gastrointestinal bleeding, ulcers, heart disease, stroke and kidney dysfunction. They can also cause water retention, which can raise blood pressure.

“NSAIDs should be taken with food and used for a limited period,” Dr. Milosavljevic says. Don’t take them several times a week or longer than a few months without discussing them with your doctor, she adds.

Doctors also caution that although pain relievers and other migraine medicines can provide relief, long-term and frequent use of the same medication can result in rebound headaches. These can start after your pain medicine has worn off, leading you to take another dose.

Rebound headaches are much more difficult to treat, Dr. Isaacs says. Over time, you can get a headache whenever you stop taking your pain medicine.

To help avoid rebound headaches, he says that doctors may vary the treatments rather than rely on a single approach.

Menstrual migraine treatment #6: Triptans “Triptans and/or NSAIDs are the top therapies after the onset of menstrual migraine,” Dr. Milosavljevic says.

That’s because triptan medications, which act on chemical receptors in the brain, can relieve pain, nausea and sensitivity to light that characterizes migraines. They also narrow blood vessels in the brain, helping reduce stretching and swelling.

They’re especially helpful if you have moderate to severe headaches that interfere with your ability to perform daily tasks. Like NSAIDs, triptans can be taken pre-emptively, Dr. Grosberg says.

“Triptans started 2-3 days before menses and continued for five days have shown to be effective,” Dr. Milosavljevic says.

If you don’t get relief with one type of triptan, ask your doctor about trying a different one.

Triptans can also be effective against non-migraine headaches, but it’s important to know which kind you have.

“A lot of women say they have migraines, but it turns out to be [just] a headache,” Dr. Isaacs says. “It can be difficult to make the distinction.”

Learning to tell the difference, and to describe what you’re experiencing with greater detail, will help doctors treat your pain more effectively, he says.

Headaches generally involve pain on both sides of the head that’s constant, not throbbing. They can include pressure that makes your head feel like it’s in a vise, with aching at the back of your head and neck, Dr. Isaacs says.

Migraines generally include throbbing pain and start on one side of your head. They’re also characterized by visual disturbance, nausea and vomiting, and also by tingling or partial paralysis, he explains.

“If it’s just headache with no other symptoms, it’s less likely to be a migraine,” Dr. Isaacs says.

But that’s not always the case, he adds: “You can have a migraine that just hurts your head, without accompanying nausea or other symptoms.”

Side effects of triptans include nausea, dizziness and muscle weakness.

Menstrual migraine treatment #7: Cardiovascular drugs – beta-blockers or calcium channel blockers You may be a good candidate for these blood pressure medications if you experience more than two debilitating migraines a month, your headache pain is interfering with your life and pain-relieving medications aren’t bringing relief.

They can reduce the frequency, severity and length of menstrual migraines and may increase the effectiveness of symptom-relieving medicines used during migraine attacks, Dr. Isaacs says.

Your doctor may recommend that you take these daily, or only when predictable migraine triggers, such as your period, are approaching.

Beta-blocker drugs, such as propranolol, Inderal and Toprol, treat high blood pressure and coronary artery disease by relaxing blood vessels, which can also reduce the frequency and severity of migraines.

The side effects, Dr. Isaacs says, may include low blood pressure, fatigue and weight gain, and they can make asthma worse. Also, watch for dizziness, drowsiness or lightheadedness.

“According to estimates, beta-blockers may decrease metabolism by 100 calories per day,” Dr. Isaacs says. “That means you’d gain a pound every 35 days [with the same caloric intake]. I personally don’t prescribe a lot of beta-blockers because of side effects.”

Calcium channel blockers, another class of cardiovascular drugs, include verapamil, Cardizem and Procardia. They also help with migraine attacks by reducing the constriction of blood vessels.

They’ve been used to treat high blood pressure for more than 20 years, Dr. Isaacs says.

The side effects of calcium channel blockers include edema (water retention), swelling and constipation.

For more information and expert advice, visit Lifescript’s Migraine Health Center.

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