A migraine attack can occur once in a month, once a week or even once every day and hence it is episodic. It occurs in the brain and nerves and so is neurological and therefore, migraine is defined as an episodic neurological disorder.
The migraine attack may occur for the first time for boys at about 10 years of age and for girls, the peak age for experiencing a migraine is near 14 years, during their first menstrual period. So, it is sensible to conclude that migraines may be hormonally related and is often referred to as a menstrual migraine.
When compared to other migraines, menstrual migraines last longer, are more severe, occur more often with nausea and vomiting and are more difficult to treat. Migraines are related to changes in the level of estrogen during a woman's menstrual cycle, which drops immediately before the start of menstrual flow.
Premenstrual migraines regularly occur during or after the time when the female hormones estrogen and progesterone decrease to their lowest levels. But generally, migraine attacks disappear during pregnancy. Women who undergo hormone replacement therapy for menopause and those who take birth control pills experience change in the frequency or severity of migraine headaches.
Strictly, a menstrual migraine is the one, which starts from two days before to three days after the first day of period and occurs around most of the periods. There are two types of migraine; pure menstrual migraine is the one, which occurs only around periods and not at other times and menstrual associated migraine is the other that occurs around the periods and at other times too.
Migraines become more frequent while a woman approaches the menopause, since the level of estrogen tends to fluctuate at this stage. However, once past the menopause, the number of migraines tends to reduce. A migraine diary maintained for three months or so helps to see the pattern of migraines and confirm it as a menstrual migraine.
For women, who have a severe menstrual migraine, it is better to prevent them before the attack -at least to make it less frequent and less severe. It is good to maintain a dairy to compare before and after treatment. Once the migraine attack takes place, the treatment for it is the same as for other causes of migraine, such as anti-inflammatory painkillers and taking estrogen supplements.
Anti inflammatory painkillers can be used to treat migraine attacks and a short course can be used to treat as soon as the period starts, until the end of the menstrual period. But people who have duodenal ulcer or asthma cannot take such medications. A few days use of anti-inflammatory pill will have no side effects. Another option for treatment of menstrual migraine is to enhance the level of estrogen just before and during the periods, which is like hormone replacement therapy just for seven days each month.
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