How to relieve headaches during menstruation?

This is the 4879th article of Da Yi Xiao Hu

During those days of each month, many girls experience headaches, accompanied by abdominal pain and a feeling of heaviness in the lower abdomen. In severe cases, they are unable to work or study. What is the reason for this? Today we will talk about menstrual migraine.

1. What is menstrual migraine? How to classify it?

Migraine attacks that occur in women during menstruation, at least twice in three consecutive months of menstrual cycles, are called simple menstrual migraine. They can be divided into two types according to the presence or absence of aura: simple menstrual migraine without aura and simple menstrual migraine with aura. The menstruation we are talking about here refers to the normal menstrual cycle or endometrial bleeding caused by the withdrawal of exogenous progesterone caused by the use of combined oral contraceptives or cyclical hormone replacement therapy. The menstrual cycle includes 1-2 days before menstruation to the 1st to 3rd day of menstruation. If headache attacks occur at other times of the menstrual cycle, we call it menstrual-related migraine, which is also divided into two types according to the presence or absence of aura: menstrual-related migraine without aura and menstrual-related migraine with aura.

Why are menstrual headaches divided into so many detailed types? This is closely related to the treatment methods we will talk about next. The significance of distinguishing simple menstrual migraine from menstrual related migraine is that hormone preventive therapy may be more effective for the former.

2. How to treat menstrual migraine?

1. Non-drug treatment

Similar to other types of migraine treatment, non-pharmacological approaches are the basis of all treatment approaches.

Patient education should be carried out throughout the whole process of migraine. First of all, it can help patients record headache diaries, identify the triggers of migraine attacks, evaluate the efficacy, follow up regularly, and adjust the intervention plan in a timely manner. There are currently paper versions of headache diaries, as well as some electronic versions of headache diaries. Various small program APPs are also under development. I believe that they will be popularized in the near future. Secondly, develop a healthy lifestyle, such as regular exercise and work and rest, limit red wine intake, avoid various inducements, etc. Finally, establish reasonable treatment expectations, that is, know the fact that migraine cannot be cured at present, but it can be effectively controlled, that is, through treatment, the frequency of attacks can be reduced, the severity of headaches can be reduced, the duration of headache attacks can be shortened, and disability can be reduced. In addition, behavioral therapy and mindfulness therapy can also be considered, mainly including relaxation training, biofeedback and cognitive behavioral therapy, which can be used as auxiliary treatments.

2. Drug treatment

Classic drugs can be used for acute treatment. Non-specific drugs include acetaminophen, NSAIDs (such as ibuprofen, diclofenac, naproxen and aspirin) and their compound preparations. Specific drugs include triptans such as zolmitriptan, rizatriptan, sumatriptan, eletriptan, frovatriptan, naratriptan and almotriptan; CGRP receptor antagonists such as ubagepam, remegipam, atrogepam and zavigepam. Some of these new therapeutic drugs have not yet been launched in China, and some have just been used in China. For specific usage methods, it is recommended to go to the neurology headache clinic to find a professional headache specialist for diagnosis and treatment.

Because of the particularity of menstrual migraine, hormone preventive therapy can be considered for simple menstrual migraine. The dosage and frequency of the drugs used vary according to age. It is best to consult a professional gynecologist.

Menstrual headaches are a relatively common headache for girls. I hope this article can be of some help to you and keep you away from the troubles of menstrual headaches.

Department of Neurology, The Second Hospital of Jilin University

Written by: Zhu Bochi, attending physician

Reviewer: Man Yuhong, Chief Physician