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Migraine Awareness Week

From 1st-7th September, WUKA is recognising Migraine Awareness Week to raise the awareness of the health condition and to help reduce stigma, particularly in light of menstrual migraines.

Menstrual Migraines

A migraine is not just a headache- and around three times more women then men are reported to suffer from them, with up to 60% linking them to their menstrual cycle. Menstrual migraines are a type of migraine.

Dr Stuart Sanders, GP at The London General Practice , told us:
“Menstrual migraine occurs during the 24 hours before the period starts and/or in the first two days of menstruation. 
The cause is thought to be due to cyclical changes of the female hormone blood levels, possibly the drop in the estrogen level.“

Many women who experience menstrual migraines, also known as hormone headaches, usually experience their first symptoms either just before their period starts, or after their cycle has begun.

And while headaches are also commonly experienced by many women during their period too, a migraine has some pretty specific symptoms. Sufferers can experience an intense, throbbing pain on one side of the head, with many feeling unable to continue with normal activities while it’s happening. According to the NHS, additional symptoms may also include nausea, vomiting and a sensitivity to bright lights.

Migraines occur in stages, but not everyone will experience them all. For the majority of sufferers, these stages are:

• The prodromal stage (also known as the pre-headache stage), where there are changes in mood and energy levels. This stage can take place either hours or days before the migraine occurs.

• The aura stage, involving issues with vision- with many reporting seeing flashing lights or blind spots. This stage can last for anywhere between 5 minutes to an hour.

• The headache stage, where sufferers experience intense pain on one side of the head.

• The resolution stage, where symptoms begin to fade.

Women who suffer from menstrual migraines don’t usually experience the aura stage. Migraines usually last on average for around 4 hours, but some can experience symptoms for up to 3 days. Some women may experience migraines at other times of the month too, while some will only experience them during their period.

Why Do You Get Headaches While On Your Period?

Headaches during your period are common, and its all due to hormones. As levels of oestrogen and progesterone fall towards the end of your cycle, headaches are more likely to occur- and as your period starts they begin to rise again, which usually brings relief and an easing of symptoms.

Dr. Belinda Coker, GP and founder of Your Trusted Squad, explains more: “Oestrogen can increase the levels of a chemical called serotonin, a substance that helps nerves, muscles and glands to function. Serotonin  can help reduce pain and discomfort and improve mood.

Therefore low levels of oestrogen and serotonin can affect mood and the sensation of pain. Oestrogen also affects the small blood vessels to the brain causing them to to dilate and provide blood supply to the brain.

Low oestrogen can lead to constriction  of the blood vessels, temporarily reducing blood flow to areas of the brain leading to throbbing migraine. 

Additionally, levels of prostaglandins can be higher during your period. Prostaglandins are hormone like substances  responsible for inflammation and pain experienced during menstrual cramps/period pains and menstrual migraine.”

Headaches that occur during your period are also sometimes called hormone headaches, but they’re not the same as menstrual migraines. The headaches you experience during your period are usually accompanied by an ache that can be resolved quickly with over the counter mediation, and there aren’t usually any other symptoms to go with it.

Some women also experience these hormone headaches during the menopause too- again due to changes in hormone levels.

Pure Menstrual Migraine vs Menstrual-Associated Migraine

A pure menstrual migraine is a migraine that occurs due to the falling levels of oestrogen in the body that take place during your menstrual cycle.

A menstrual-associated migraine is also caused by these same hormones, and also takes place during your menstrual cycle- but the symptoms are very different.

Symptoms of a menstrual-associated migraine, or hormone headache, are usually less intense and more easily treated with pain relief. These symptoms tend to last for a short while and don’t usually interfere with your everyday routine.

A menstrual migraine can be debilitating, with sufferers reporting that they are unable to enjoy their usual activities as normal. Often the intense pain to one side of the head is couple with other PMS symptoms such as fatigue, changes in mood, food cravings, tummy upset and joint pain/ muscle aches.

According to the National.Migraine Centre, another big difference is that menstrual migraines are more likely to recur the next day after an attack, only receding as levels of oestrogen begin to rise.

So if you usually suffer from migraines at other times of the month, your usual symptoms may last longer and usual medications may not be as effective.

    Diagnosing Menstrual Migraine

    It isn’t always easy to know whether or not you’re experiencing a menstrual migraine because some women may experience symptoms without a severe headache, making diagnosis difficult.

    If you’re concerned about menstrual migraines, it’s always a good idea to seek medical advice from your GP, who might refer you for more tests to find out what’s going on.

    You might also find it helpful to keep a track of any symptoms you experience, when they occur and how intense they are. This will make it easier to determine if your migraine is associated with your cycle. It’s also a good idea to keep a track of ‘non-hormonal triggers’- things that can bring on a migraine attack, such as alcohol, caffeine, and over-tiredness. Avoid these triggers if you can.

    Treatment Options for Menstrual Migraine

    Speak to your doctor about the different treatment options available to you, menstrual migraines can really impact your life and can be excruciatingly painful, so there’s no need to suffer in silence. 

    Your doctor might recommend one of the following treatment options:

    • Non-steroid Anti-Inflammatory drugs (NSAIDS).

    • Medications that are specifically designed to treat migraines, read more from the NHS.

    • Oestrogen supplements, these work by preventing the drop in oestrogen levels but can only be used if you periods are regular.

    • Certain hormonal birth control medications. These help to maintain a stable level of hormones in the body, thus eliminating the drop in oestrogen that can trigger menstrual migraines

    Herbal Remedies for Menstrual Migraine

    Your doctor might recommend a course of acupuncture if you’ve already tried medication and it hasn’t been effective or you might decide to explore other, more natural remedies first.

    There are also some herbal remedies that could help, either by helping to prevent an attack, or by easing symptoms during an attack.

    • Ginger Tea could be helpful in easing the nausea associated with migraines- although no studies have been found to prove it helps, lots of women anecdotally report an improvement in symptoms.

    • Essential oils, again so specific studies show conclusively that aromatherapy is effective, but certain essential oils such as lavender and peppermint are though to soothe the symptoms of headaches, so it might be worth a try.

    • CBD, an oil derived from the leaves of cannabis plants. Initial research has found that CBD can help to relieve pain and nausea.

    • Magnesium could be effective in preventing a migraine attack; it’s known to be essential in supporting muscle end nerve function, blood glucose levels, blood pressure regulation and energy production in the body. Plus, studies have found that those suffering from migraines were also deficient in this mineral.

    • Vitamin B2 can be found naturally in red meat, eggs, nuts, beans, green leafy vegetables and dairy products. One study found B2 to be effective in reducing the frequency and length of a migraine attack, but make sure you tell your doctor before you start taking it.

    • Coenzyme Q10 (CoQ10)- the name given to a vitamin-like substance that helps to create adenosine triphosphate, which is the main source of energy in for all the cells in the body. Two studies have been done that show a drop in symptoms when supplementing with CoQ10.

    • Feverfew is a plant closely related to chrysanthemums, and studies have shown that it could help to reduce symptoms of pain.

    • Butterbur is a perennial shrub known to help reduce the frequency of migraine attacks, but speak to your doctor before taking this as there could be some side effects to consider.

    As with all herbal remedies, always do your research and speak to your GP before taking anything, especially if you’re already on medication for migraines. Some supplements may not be safe to take alongside other courses of treatment.