Hormone-related migraines make monthly periods really seem like "the curse." Migraines afflict three times as many women as men, according to the Merck Manual. They start around puberty and peak in frequency and intensity at middle age, declining after menopause. According to the Merck Manual, migraines can be chronic and inherited. The exact cause for migraines is still under investigation, and although there is no cure, there are effective ways to help prevent and treat attacks.
Researchers now believe that migraines are a result of a disorder of the nervous system in which over-sensitive nerve cells produce inappropriate electrical signals that spread over the brain. The Merck Manual states that the errant signals result in visual changes and altered sense of taste and balance--known as auras. These phenomena are precursors of migraines for some women. Electrical impulses eventually reach and stimulate the fifth cranial or trigeminal nerve, which usually sends pain signals from jaw, eyes and scalp to the brain. In a July 2010 article in the "New England Journal of Medicine," Elizabeth Loder, M.D., M.P.H., states that the triggered nerve releases substances that inflame cerebral blood vessels and tissues covering the brain. Inflammation then triggers classic migraine symptoms.
Migraine headache pain can be moderate to severe. Sufferers report throbbing pain on one or both sides of the head. Sometimes nausea, with or without vomiting, accompanies the headache, as does sensitivity to light, sound and odors. Migraines typically last for a few hours, but they can continue for up to three days, according to the Merck Manual. Migraines can disappear for months or even years, only to return.
Factors and Triggers
Researchers continue to investigate what instigates migraines. Correlations between a woman's reproductive cycles and occurrences suggest a link between estrogen levels and migraines. Sudden drops in the hormone prior to menstruation may play a role in concurrent drop in serotonin levels in the brain also associated with migraines. Women approaching menopause sometimes have fluctuating hormone levels, so perimenopausal women can experience worsening symptoms during this time. Menopause usually relieves fertility-related migraines, as does pregnancy, according to the Merck Manual.
Preventive measures include taking beta-blockers, such as atenolol and propranolol. The beta-blockers, usually prescribed for people with cardiovascular disease, slow down heart rate and also reduce the number and severity of migraine attacks. Calcium-channel blockers, such as verapamil, also do dual duty as cardiac medication and migraine prevention. The medications are not appropriate for those people with certain underlying conditions and diseases. Anticonvulsants, such as Depakote or Topamax, also help limit migraine attacks, according to the Merck Manual. The exact mechanism behind the effect remains under investigation. Some doctors recommend taking diuretics in the days leading up to a woman’s monthly period as excess water retention sometimes helps trigger migraine attacks.
Any stress can worsen symptoms and lengthen the duration of an attack. Lying down in a dark quiet room helps. Some find cool compresses applied to the forehead beneficial.
Analgesics, such as Tylenol, can help relieve mild to moderate pain. Manufacturers make some analgesics with caffeine, reported to improve some migraine symptoms. Non-steroidal anti-inflammatory drugs, such as aspirin, can also provide relief. Continued high dosages of either medication can actually worsen a headache, or cause rebound headaches when a woman abruptly stops taking it.
Severe migraine pain unaffected by analgesics or anti-inflammatory medications sometimes responds to opiodes, such as codeine. Codeine has side effects, including drowsiness and potential addiction. Classes of drugs called "triptans," such as sumatriptan, work to interrupt the irritation of the nervous system rather than masking the pain caused by it. Doctors can prescribe nasal sprays or other forms of self-application. Those suffering from intense pain rely on the triptans for relief, according to the "New England Journal of Medicine." Anti-emetics can help severe nausea that sometimes accompanies migraines