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Menstrual migraine

Anne H Calhoun
Unnecessary confusion still surrounds the use of combined hormonal contraceptives (CHCs) in the setting of migraine with aura (MwA). Clearing this confusion is a key issue for headache specialists, since most women with migraine have menstrual-related migraine (MRM), and some CHCs can prevent this particularly severe migraine. Their use, however, is still restricted by current guidelines due to concerns of increased stroke risk - concerns that originated over half a century ago in the era of high dose contraceptives...
October 24, 2016: Headache
Gianni Allais, Chiara Benedetto
Migraine is a common neurovascular disorder, affecting millions of people worldwide. Current guidelines recommend triptans as first-line treatment for moderate-to-severe migraine attacks. Frovatriptan is a second-generation triptan with a longer terminal elimination half-life in blood than other triptans (~26 hours). Three double-blind, randomized crossover preference studies have been recently conducted, assessing efficacy and safety of frovatriptan versus rizatriptan, zolmitriptan, and almotriptan, respectively...
2016: Drug Design, Development and Therapy
Anne H Calhoun, Nicole Gill
BACKGROUND: This retrospective observational study describes what appears to be a not-uncommon yet not previously typified headache disorder, "end-menstrual migraine" (EMM) named for its proximate occurrence with the terminal days of menstrual bleeding each month. METHODS: Our menstrual migraine (MM) clinic's database was queried for patients with migraine, regular menses, and the locally used diagnostic code of EMM, signifying the patient's assertion that she had migraine at the end of menses as well as calendar data confirming that association...
October 5, 2016: Headache
Licia Grazzi, Gabriella Egeo, Anne H Calhoun, Candace K McClure, Eric Liebler, Piero Barbanti
BACKGROUND: Menstrual migraine and menstrually related migraine attacks are typically longer, more disabling, and less responsive to medications than non-menstrual attacks. The aim of this study was to evaluate the efficacy, safety, and tolerability of non-invasive vagus nerve stimulation for the prophylactic treatment of menstrual migraine/menstrually related migraine. METHODS: Fifty-six enrolled subjects (menstrual migraine, 9 %; menstrually related migraine, 91 %), 33 (59 %) of whom were receiving other prophylactic therapies, entered a 12-week baseline period...
December 2016: Journal of Headache and Pain
Khatera Ibrahimi, Steve Vermeersch, Pascal Frederiks, Vincent Geldhof, Cedric Draulans, Linde Buntinx, Emmanuel Lesaffre, Antoinette MaassenVanDenBrink, Jan de Hoon
BACKGROUND: Migraine is much more common in females than in males, and occurrence is associated with changes in female sex hormones. Calcitonin gene-related peptide (CGRP) plays a key role in migraine, and variations in female sex hormones may affect CGRP sensitivity and/or production. OBJECTIVES: Investigate repeatability, gender differences, influence of the menstrual cycle and of migraine on CGRP-dependent changes in dermal blood flow (DBF). METHODS: CGRP-dependent increases in DBF were assessed using laser Doppler perfusion imaging after topical application of 300 or 1000 µg capsaicin on the forearm of healthy subjects and migraine patients...
September 28, 2016: Cephalalgia: An International Journal of Headache
Roberto De Icco, Laura Cucinella, Irene De Paoli, Silvia Martella, Grazia Sances, Vito Bitetto, Giorgio Sandrini, Giuseppe Nappi, Cristina Tassorelli, Rossella E Nappi
BACKGROUND: Menstrually-related headache and headaches associated with oestrogen withdrawal are common conditions, whose pathophysiology has not been completely elucidated. In this study we evaluated the influence of combined hormonal contraceptives (CHC) on pain threshold in women presenting migraine attacks during hormone-free interval. FINDINGS: Eleven women with migraine attacks recurring exclusively during the oestrogen-withdrawal period were studied with the nociceptive flexion reflex, a neurophysiological assessment of the pain control systems, during the third week of active treatment and during the hormone-free interval...
December 2016: Journal of Headache and Pain
Wachirapong Saleeon, Ukkrit Jansri, Anan Srikiatkhachorn, Saknan Bongsebandhu-phubhakdi
BACKGROUND: Many women experience menstrual migraines that develop into recurrent migraine attacks during menstruation. In the human menstrual cycle, the estrogen level fluctuates according to changes in the follicular and luteal phases. The rat estrous cycle is used as an animal model to study the effects of estrogen fluctuation. OBJECTIVE: To investigate whether the estrous cycle is involved in migraine development by comparing the neuronal excitability of trigeminal ganglion (TG) neurons in each stage of the estrous cycle...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Kevin Anderson, Oksana Burford, Lynne Emmerton
OBJECTIVE: Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps...
2016: PloS One
Kyung Soo Kim
The authors experienced a patient of fibrous dysplasia originating from the ethmoid bone which presented with severe headache with some features suggestive of menstrual migraine without aura. Fibrous dysplasia originating from the ethmoid bone is a rare disease entity, but may cause severe headache that can be misdiagnosed as "menstrual migraine" because of similar symptoms in female patients. Because the primary objective of surgery is symptomatic relief, conservative transnasal endoscopic approach may be considered an alternative to more invasive external surgical techniques in carefully selected patients, especially originating from the nasal cavity and paranasal sinuses...
June 2016: Journal of Craniofacial Surgery
Laura H Schulte, Arne May
Functional imaging using positron emission tomography and later functional magnetic resonance imaging revealed a particular brainstem area that is believed to be specifically activated in migraine during, but not outside of the attack, and consequently has been coined the 'migraine generator'. However, the pathophysiological concept behind this term is not undisputed and typical migraine premonitory symptoms such as fatigue and yawning, but also a typical association of attacks to circadian and menstrual cycles, all make the hypothalamus a possible regulating region of migraine attacks...
July 2016: Brain: a Journal of Neurology
Roger K Cady, Kathleen Farmer
For the last quarter of a century, triptans have been available for acute treatment of migraine but with little guidance on which of the different triptan products to use for which patient or which attack of migraine. In this article, we propose a structured approach to analysis of individual migraine attacks and patient characteristics as a means of defining and optimizing acute intervention. Assessment of patient and attack profiles includes the "5-Ps": pattern, phenotype, patient, pharmacology, and precipitants...
2016: Patient Preference and Adherence
Ann Pakalnis
This article discusses the role that hormones play in adolescent girls and young women with headaches, which are very common in adolescent girls, in particular, migraine. In many cases, migraine onset may occur shortly around the time of menarche, prevalence of recurrent migraine in this population approaches 15%, and typically the symptoms continue through adulthood. Hormonal changes associated with puberty and the menstrual cycle may significantly influence migraine in young women. This article reviews the following topics: management of menstrually related headaches, changes in ovarian hormones and their relationship to migraine, and oral contraceptives and pregnancy effects on migraine...
February 2016: Seminars in Pediatric Neurology
Selen Gür-Özmen, Ruhan Karahan-Özcan
OBJECTIVE: .  Association between iron deficiency anemia (IDA) and migraine, its subgroups, or tension-type headache (TTH) has not yet been shown. This study aimed to determine whether there was an association between IDA and these disorders. DESIGN: .  Case-control study. SETTING: .  Gebze Fatih General Hospital, Kocaeli, Turkey. SUBJECTS: .  Migraine and TTH patients, as well as healthy controls (N = 170/group), were investigated...
December 14, 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Vincent T Martin, Jelena Pavlovic, Kristina M Fanning, Dawn C Buse, Michael L Reed, Richard B Lipton
OBJECTIVES: To examine the relationship of headache frequency to the stages of the menopausal transition in mid-life women with migraine. BACKGROUND: Past studies suggest that the perimenopause is associated with an increased prevalence of migraine, particularly in those with a history of premenstrual syndrome. The effect of the menopausal transition on the frequency of headache attacks in women with migraine has not been explored. METHODS: This was a cross-sectional observational study...
February 2016: Headache
Gianni Allais, Giulia Chiarle, Fabiola Bergandi, Chiara Benedetto
Migraine is a debilitating neurovascular disorder which is estimated to affect 18% of women and 6% of men. Two main forms of this neurological disorder must be considered: Migraine without Aura and Migraine with Aura. Migraine without aura often has a strict menstrual relationship: the International Headache Society classification gives criteria for Pure Menstrual Migraine and Menstrually Related Migraine. The higher prevalence of migraine among women suggests that this sex difference probably results from the trigger of fluctuating hormones during the menstrual cycle...
2016: Expert Review of Neurotherapeutics
Ligia Oliveira Gonçalves Morganti, Márcio Cavalcante Salmito, Juliana Antoniolli Duarte, Karina Cavalcanti Bezerra, Juliana Caminha Simões, Fernando Freitas Ganança
INTRODUCTION: Vestibular migraine (VM) is one of the most often common diagnoses in neurotology, but only recently has been recognized as a disease. OBJECTIVE: To analyze the clinical and epidemiological profile of patients with VM. METHODS: This was a retrospective, observational, and descriptive study, with analysis of patients' records from an outpatient VM clinic. RESULTS: 94.1% of patients were females and 5.9% were males...
July 2016: Brazilian Journal of Otorhinolaryngology
Azam Karkhaneh, Mohammad Ansari, Solaleh Emamgholipour, Mohammad Hessam Rafiee
OBJECTIVES: The neuropeptide calcitonin gene-related peptide (CGRP) has long been postulated to play an integral role in the pathophysiology of migraine. Earlier studies showed that CGRP can stimulate the synthesis and release of nitric oxide (NO) and cytokines from trigeminal ganglion glial cells. The purpose of this study was to determine the effect of 17β-estradiol in regulation of CGRP expression, inducible nitric oxide synthase (iNOS) activity, and NO and interleukin-1beta (IL-1β) release in cultured peripheral blood mononuclear cells (PBMCs) from patients with pure menstrual migraine and healthy individuals...
September 2015: Iranian Journal of Basic Medical Sciences
Min Shi, Lisa A DeRoo, Dale P Sandler, Clarice R Weinberg
Migraine headache is often timed with the menstrual cycle. Some studies have reported reduced risk of breast cancer in migraineurs but most of those did not distinguish menstrually-related from non-menstrually-related migraine. To examine the possible associations between breast cancer and migraine overall and between cancer subcategories and the two migraine subtypes, we used a cohort study of 50,884 women whose sister had breast cancer and a sister-matched case-control study including 1,418 young-onset (<50 years) breast cancer cases...
October 12, 2015: Scientific Reports
Hida Del C Nierenburg, Jessica Ailani, Michele Malloy, Sara Siavoshi, Nancy N Hu, Nadia Yusuf
OBJECTIVE: The aim of this systematic review is to identify the efficacy of different categories of treatments for menstrual migraines as found in randomized controlled trials or open label studies with similar efficacy endpoints. BACKGROUND: Menstrual migraine is very common and approximately 50% of women have increased risk of developing migraines related to the menstrual cycle. Attacks of menstrual migraine are usually more debilitating, of longer duration, more prone to recurrence, and less responsive to acute treatment than nonmenstrual migraine attacks...
September 2015: Headache
E Anne MacGregor
PURPOSE OF REVIEW: Migraine is most prevalent in women during their reproductive years. An understanding of the effects of menstruation and menopause on migraine can enable neurologists to provide targeted and appropriate medical and hormonal strategies, enabling their patients to achieve better control of migraine and reduced disability. This article reviews the effects of hormonal events on migraine and summarizes the evidence-based options available for management. RECENT FINDINGS: Estrogen "withdrawal" during the late luteal phase of the natural menstrual cycle and the hormone-free interval of combined hormonal contraceptives has long been implicated in the pathophysiology of menstrual migraine...
August 2015: Continuum: Lifelong Learning in Neurology
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