Menstrual Headache/Migraine

Menstrual migraine or menstrual headache is the occurrence of a migraine or headache before or during menstruation which is thought to be due to a reduction in oestrogen and/or increased levels of prostaglandins. Triptans and nonsteroidal anti-inflammatory drugs (NSAIDs) can help to alleviate the associated pain. Some women benefit from additional oestrogen before the expected onset of menstruation or the use of continuous hormonal treatment in the form of the combined oral contraceptive pill ( COCP) without a 7 day break if there is no contra-indication, or an oestrogen patch or gel in combination with a progesterone releasing Mirena coil or micronised progesterone so as to avoid hormonal fluctuations.