Acute and preventive management of migraine during menstruation and menopause
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Authors
Ornello, Raffaele
Matteis, Eleonora De
Felice, Chiara Di
Caponnetto, Valeria
Pistoia, Francesca
Sacco, Simona
Issue Date
2021-05-24
Type
Article
Language
en_US
Keywords
Migraine , Menstruation , Menopause , Migraine Treatment , Triptans , Hormonal Treatments
Alternative Title
Abstract
Migraine course is influenced by female reproductive milestones, including menstruation and perimenopause; menstrual migraine (MM) represents a distinct clinical entity. Increased susceptibility to migraine during menstruation and in perimenopause is probably due to fluctuations in estrogen levels. The present review provides suggestions for the treatment of MM and perimenopausal migraine. MM is characterized by long, severe, and poorly treatable headaches, for which the use of long-acting triptans and/or combined treatment with triptans and common analgesics is advisable. Short-term prophylaxis with triptans and/or estrogen treatment is another viable option in women with regular menstrual cycles or treated with combined hormonal contraceptives; conventional prevention may also be considered depending on the attack-related disability and the presence of attacks unrelated to menstruation. In women with perimenopausal migraine, hormonal treatments should aim at avoiding estrogen fluctuations. Future research on migraine treatments will benefit from the ascertainment of the interplay between female sex hormones and the mechanisms of migraine pathogenesis, including the calcitonin gene-related peptide pathway.
Description
Citation
Ornello, R., De Matteis, E., Di Felice, C., Caponnetto, V., Pistoia, F., & Sacco, S. (2021). Acute and Preventive Management of Migraine during Menstruation and Menopause. Journal of clinical medicine, 10(11), 2263. https://doi.org/10.3390/jcm10112263
Publisher
Journal of Clinical Medicine