Saturday, June 02, 2007

How to Manage Hormonal Headaches

Menstrual Migraines
How to Manage Hormonal Headaches
Source:  Lisa Zamosky, Special to LifeScript

Of the estimated 28 million people in the United States who suffer from migraine headaches, the majority are women. And according to the National Headache Foundation, approximately 70% of them get menstrual migraines – migraines that strike before, during, and just after a woman's period or during ovulation. What can you do to avoid the triggers and treat a menstrual migraine?

What Causes Menstrual Migraines?
Blame it on your hormones. Estrogen and progesterone regulate your menstrual cycle and alter your production of brain chemicals like serotonin, which can trigger a headache.

Another culprit: Before your period starts your estrogen levels drop, causing inflammatory changes that can give you a migraine, according to George Nissan, M.D., staff physician and director of research at the Diamond Headache Clinic in Chicago.

Taking birth control pills, which alter estrogen levels, can also make women susceptible to hormonally triggered migraines as can the first trimester of pregnancy.

What are the Symptoms?
Menstrual migraine symptoms are the same as those of any other migraine, according to Ludmilla Bronfin, M.D., assistant professor in the department of neurology with NYU's School of Medicine.

Only the timing of the headaches distinguishes them.

"Women with menstrual migraines often have regular migraines, too, but their headaches are mostly tied to their menstrual cycle," Bronfin says.

Migraines typically cause throbbing pain on one side of the head, which is aggravated by movement, light and sound.

Nausea is also common.

Some women experience an aura – changes in their vision that cause them to see bright or zigzagged lines – just before the onset of a menstrual migraine.

How Do You Treat a Menstrual Migraine?
Start with non-prescription medications, such as acetaminophen, aspirin, Excedrin, or ibuprofen. A combination of aspirin or acetaminophen and caffeine can help, too. If you get migraines during your period, begin taking pain medication a few days before it starts and continue until your period ends. Don't go over the recommended dosage, though; taking too much non-prescription pain medicine can trigger rebound headaches. Follow the dosage recommendations on your pain reliever of choice.

It's also a good idea to talk with your doctor if you suffer from migraines regularly. Physicians often prescribe headache medications called triptans, which can be taken before and during menstruation to head menstrual migraines off at the pass, Nissan says. Oral contraceptives may help, too. "Sometimes we'll suggest a woman take oral contraceptives three months at a time so she'll skip her period," Nissan says. However, he cautions that skipping a period doesn't guarantee that you'll skip a headache.

If you are already taking birth control pills and are having headaches, Bronfin suggests asking your doctor about switching to low estrogen pills or changing birth control methods.

Can Lifestyle Changes Cure Migraines?
Healthy habits can often stave off or minimize menstrual migraines, according to doctors.

Here's what you can do:

Watch what you eat and drink.
Decrease caffeine, aged cheeses, red wine, cured meats, and Chinese and Thai foods, which are frequently prepared with monosodium glutamate (MSG). "These are the big triggers," Nissan says. Also be sure to eat at regular intervals; skipping meals and fasting can cause headaches.

Stick to a sleep schedule.
Avoid getting too much or too little sleep; both can trigger a migraine. Go to sleep and get up at the same time every day, even on weekends, Bronfin advises.

Reduce stress through relaxation.

Exercise regularly.
Nissan suggests doing some type of aerobic exercise four to five times per week to improve overall health and prevent headaches.


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