[Menstrual migraine]

Abstract

Background: Migraine is twice as prevalent in women than men. Changing levels of estrogen appear to trigger menstrual migraine. This article reviews clinical characteristics, pathophysiology and treatment of menstrual migraine.

Material and methods: This review is based on literature retrieved from a non-systematic search of PubMed (up to January 2008) with the search terms "menstrual migraine" and "menstrual migraine and treatment".

Results and interpretation: Pure menstrual migraine without aura is probably a distinct type of migraine caused by a fall in estrogen levels before the onset of menstruation. Women with menstrual migraine can receive prophylactic treatment in the perimenstrual period. There is no evidence that hormonal prophylaxis is more effective than non-hormonal. Because of an increased risk of thromboembolic events, hormonal treatment should only be given to women who have failed to respond to other treatment or to those who need hormonal treatment due to comorbidity.