Menstrual Migraines (7th Nov 2019)
Is it a widely held belief that Menstrual related Migraines are due to declining levels of estrogen at certain times in the menstrual cycle.
A recent paper in the Journal of Headache by Calhoun (Calhoun AH. Understanding menstrual migraine. Headache 2018; 58: 626-630) concludes that: Rapid estrogen level declines occurring naturally or iatrogenically are the most common cause for menstrual migraine.
When headache diaries of 81 patients with menstrual migraines were combined, Calhoun found their headaches occurred during the declining phase of estradiol. Somerville was able to ameliorate most menstrual migraines by adding estradiol back at the time of the estrogen level decline.
Lichten and colleagues were able to trigger migraines in postmenopausal women who previously had menstrual migraines by giving an injection of estradiol cypionate. The headache occurred at 2-3 weeks after the injection when the blood levels fell but were not at their nadir.
According to Dr Jerome Dixon BAppSc(Chiro) BSc(Biochem) Editor headache.com.au : A key question for all Menstrual Migraine sufferers should be: ‘What contributing factors make you more vulnerable at that time of the month’ Logic has it that not all women who have a menstrual cycle- suffer migraines, so what makes some more vulnerable?
In practice, we commonly see menstrual migraine sufferers who can get great relief from attacks when we take a thorough history and examine common areas which contribute to attacks. Its really common to see patients with Migraines that are ‘Menstrually timed’, but have little to do with hormonal causes.
Dixon states that the history is key and a relevant examination is important.
Common problems like Food triggers, MusculoSkeletal problems in Neck/Jaw, Ear,Nose,Throat, Visual, lifestyle habits and systemic conditions-
should be identified in a thorough history; with referral to the appropriate expert(s).
Dr Dixon has a BAppSc (Chiropractic)RMIT University. BSc(Biochemistry)LaTrobe University. Undergrad(Dietetics)Deakin University
Dr Dixon is a Member COCA and completed his studies in 1995.Further postgraduate studies in Headache and Migraine management,
and case collaboration with collegues from other professions led him to the concept of www.headache.com.au. and its launch in 2000.
Dr Dixon is available for consultation and keeps up to date with all the latest research around the world.