A normal female goes through a number of hormone related changes during her lifetime: menarche, pregnancy, contraceptive use, menopause, and sex hormones. A review of literature has shown that migraine is twice as prevalent in women as men. Changing levels of female sex hormones (estrogen) have shown to trigger a form of migraine known as menstrual migraine.
Signs and symptoms:
• Pure menstrual migraine without aura is probably a distinct type of migraine caused by a fall in estrogen levels before the onset of menstruation.
• It usually presents on day 1 +/- 2 of the menstrual cycle.
• Attacks occurring at this time of the cycle are typically without aura.2
• Can accompany with nausea, backache, breast tenderness, and cramps.
Etiology:
• Migraine may be linked to late luteal phase dysphoric disorder and dysmenorrhea. These conditions occur when the greatest fluctuation of …show more content…
Most women with migraine report an improvement of their attacks during pregnancy, from the first to the third trimester. This improvement may be due to the lack of hormonal fluctuations but also to the increased levels of natural pain-killing hormones (endorphins) induced by pregnancy. If no improvement is seen toward the end of the first trimester, migraine is likely to continue throughout pregnancy and postpartum. Most women with migraine improving in pregnancy will experience attack recurrence shortly after delivery, likely in the first weeks. Women continuing to experience migraine attacks throughout pregnancy may require treatment but we need to consider that not all medications used for migraine are safe in pregnancy. Paracetamol is the preferred drug for acute treatment throughout pregnancy. If paracetamol is not sufficiently effective, sporadic use of sumatriptan can be