This article has been written by Debayani Bose with clinical inputs from Dr. Renuka Dangare.
"I have been suffering from migraine since I was a toddler. In my case, it was hereditary as my father was suffering from migraine too but on a milder scale. For me, the migraines are far more aggressive. Initially, there was no proper diagnosis and my disease got diagnosed only in my teens.That was the time when i heard the word "migraine " for the first time! Over a span of more than three decades, the disease got the better of me and i have have numerous episodes of headache and nausea.Now i am off treatment and i want to take matters in own hand.Over the years, i have identified certain triggers to episodes,like, excessive exposure to sunlight,drinking less water, lack of sleep and certain food items. I now practice very mindful eating, am able to identify the spectrum and take precautions. I try my best to stay away from stress as best as I can." --- Testimonial from a real-life patient who has been suffering from migraine.
Menstrual migraines are definitely different from a normal headache that we usually get and a condition far more serious. It can severely affect work, sleep and one's ability to complete everyday tasks.
What are migraines?
A migraine episode is not your usual headache, like a tension headache for instance. The episode usually occurs in stages and can last for many days on end. It can affect your everyday life and your ability to work.
Migraine is a neurological condition that is usually accompanied by multiple symptoms- meaning it is far more complex than we think. No one, literally not even young children are spared. Migraines affect all age groups and can be hard on you if your family member has had them. A common form of migraine for most is an intense splitting headache affecting half of your head, ear and neck, accompanied by some unpleasant nausea and vomiting. A patient with migraine will prefer curling up in a dark room with no light or sound. That worsens that nausea.
When it comes to migraines, any of the following could be a trigger
- Hormonal changes such as right around the time of your period
- When struggling with stress, anxiety, or depression
- Things you eat or drink such as alcohol, caffeine, chocolate, cheese, citrus fruits, and foods containing the additive tyramine
- Medications, such as sleeping pills, hormone replacement therapy (HRT), and birth control pills
Correlation between migraine and menstruation
There is a strong correlation between migraine and menstruation. Migraines have often been linked to the production of the feminine hormone estrogen. Estrogen controls chemicals in the brain that affect the sensation of pain. A drop in estrogen levels can trigger a headache. The migraines can last a few days before and up to the entire week of pre-menstruation and during menstruation, depending on your body. During pregnancy, many women may experience relief from their migraines as estrogen level rises and stays high for the duration of the pregnancy.
What are migraines with aura?
Migraines with aura, often termed as classic migraine, is a frequently occurring headache that strikes after or as sensory disturbances called an aura. These disturbances often include flashes of light, blind spots, and other vision changes. In most cases, the treatment for migraine with aura and without aura are the same. The exact reason for what causes an aura is not yet known. However, it’s believed that it is caused by a wave of electrical activity that spreads across the cortex of the brain. A migraine aura is typically characterized by disturbances in your vision, sensation, or speech. It can occur before or during a migraine attack and usually lasts less than 60 minutes.
How to treat a migraine with aura?
- When the aura symptoms surface, move yourself to a quiet and darkroom and close your eyes
- Place a cold compress on the forehead or the back of the neck to ease the migraine pain
- Taking a pain killer to control your pain may be useful. Some patients find that taking a painkiller as soon as they experience pain is much more effective that once the pain has fully set in.
- Consult a neurologist or brain specialist if these headaches are getting worse or impair your ability to function.
How do women's hormones affect migraines during menopause?
Premenstrual migraine: Premenstrual migraines occur during or after the time when the female hormones, estrogen, and progesterone, drop to their lowest levels.
During pregnancy: Hormonal changes during pregnancy can trigger migraine headaches. Most women experience a combination of triggers including stress, skipped meals, and lack of sleep.
Menopausal migraine: Menopause can make migraines less in severity and are usually linked to hormonal fluctuations of the menstrual cycle.
Lifestyle changes to avoid a migraine
Making changes in your lifestyle can go a long way in preventing the frequency and intensity of migraine headaches. The following lifestyle changes can be done to prevent a migraine-related headache.
- Avoid foods that may trigger a migraine: Food items such as alcohol, chocolate, cheeses, and other foods can trigger a tension headache or migraine
- Quit smoking: Smoking can hurt your lungs and also increase head pain and other symptoms
- Follow an exercise regimen: Following an exercise regimen can help reduce symptoms of migraine-related headaches
- Establish a sleep schedule: Following a regular sleep schedule can help combat stress effectively and also reduce migraine headaches
- Reduce stress: Migraines can be triggered by stress. Therefore, it’s important to handle stress well and follow it up by deep breathing and meditation exercises
- Choosing a contraceptive in a migraine: Migraines can be triggered by the consumption of oral contraceptives which usually improve over time. Often, it’s found that migraines improve with the starting of a pill. Several studies suggest that headaches are less likely to occur with the lowest dose of pills.
Conclusion
Migraine is both a common and under-treated disease and considered a major cause of disability that leads to loss of productivity and is often associated with comorbidities such as anxiety and depression. It often helps to keep a diary of the headaches, recording when they are occurring during the menstrual cycle as well as their severity and response to treatment will go a long way in determining the presence or absence of menstrual migraine.
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Disclaimer: This article is for informational purposes only and should not be construed as a substitute for medical advice or treatment.