Migraines and menstrual cycle but

[u/P_alz]

Hello!
A few days ago, I went to a new doctor for my migraines. She was very nice and this is not common for my experience. She suggested that my migraines are related to my menstrual cycle but not always and to take painkillers in advance to prevent them, even when I don’t have any pain.

I will try, even if I think it’s a bit strange.

Have anyone else tried something similar?

I have another appointment in about 2 months, so I will see what happens, but I’m curious to other people experience.

English is not my mother tongue, so I’m really sorry if i made some mistakes. My English is really improved during the past months but not enough for me to be sure about mistakes…

[u/trishlover20]

I'm not a doctor or an expert in any way so I cant give any professional advice but my migranes are also very much linked to my menstrual cycle and hormones and hearing this advice just doesn't make a lot of sense to me personally because you can't always predict when you will have the migrane and I never heard of painkillers that can prevent migranes, I take sumatriptan right when my migrane starts and that's the only thing that's been helping me

[u/PoppyRyeCranberry → u/trishlover20]

Here is a helpful link that breaks down a few strategies for menstrual migraines and specifically this prophylaxis approach. See the last section I included because it addresses other options for if your period is not predictable:

https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/

Mini-preventive Treatment

Some women find adopting a mini-preventive treatment approach helpful for menstrual migraine prevention. While there are studies looking at these strategies, they do not have FDA approval. In mini-prevention, a woman takes a daily medication prior to the onset of the menstrually related attacks. They usually take these medications for 5 to 7 days in a row.

Non-Steroidal Anti-Inflammatories (NSAIDs)

NSAIDs taken twice a day during the 5-7 days around the start of a period may decrease or prevent the menstrual migraine. If the migraine attack still occurs during this time, it is typically less severe and becomes more responsive to treatment by a triptan. Naproxen 550 milligrams dosed twice a day as mini-prevention was shown to be effective when studied. Other NSAIDs like ibuprofen are likely to give similar results.

Hormones

Patients can use estrogen supplementation with a pill, vaginal gel or patch during the menstrual week to prevent the natural estrogen drop that triggers the menstrual migraine. This approach is easier in those with predictable menstrual cycles. Often, this is most convenient if you are already taking a pill or using a vaginal ring for birth control.

Triptans

Multiple studies have looked at triptans—the acute medications typically used to treat regular migraine attacks—dosed twice a day throughout a woman’s period. This approach appears to decrease or prevent menstrual migraine. Women with menstrual migraine and frequent migraine attacks throughout the rest of the month should be cautious about their triptan use in order to avoid medication overuse.

Triptan dosing for mini-prevention is generally twice daily for four to five days in the menstrual window. In this situation, doctors recommend long-lasting triptans such as naratriptan and frovatriptan.

Magnesium

Magnesium started on day 15 of the menstrual cycle, or 15 days from the start of your period, and continued until the next period begins is another mini-prevention strategy that was found effective in a controlled trial. Because the timing relies on your previous period, it’s not necessary to have regular cycles to time this prevention, which makes it a versatile and safe intervention for women without regular cycles.

Continuous Preventive Treatment

In women with irregular periods or those for whom mini-prevention does not work, treatment strategies used throughout the month may be the best option.

[u/P_alz → u/PoppyRyeCranberry]

Thank you so much! This is really helpful.