Nonpharmacological Treatment of Menstrual Headache: Relaxation-Biofeedback Behavior Therapy and Person-Centered Insight Therapy

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Abstract

SYNOPSIS

Sixty percent of female headache sufferers have an increase paramenstrually. Although behavioraltreatment of migraine and tension headache has proven effective in controlled studies, the effect onparamenstrual increases has rarely been isolated and observed. The purpose of this study was todemonstrate the effects of two types of nonpharmacological treatment on menstrual headache: 1)relaxation with EMG and thermal biofeedback, and 2) person-centered insight therapy, as an alternativetreatment control. The design was that of the time series method. Diagnosis was made into subtypes ofmigraine, muscle-contraction, mixed and cluster headache. 16 women with paramenstrual headaches selfmonitored 4 times daily for a 2-cycle baseline, then were matched on pre-treatment pain levels into 8 pairsand randomly assigned to treatment, 12 sessions carried out over 3 cycles, with a one-month follow-upcycle. Post-treatment group data analysis was by three-way analysis of variance with 2 repeatedmeasures. There were no significant main effects of group or time, although individual clinical analysis bypercent improvement demonstrated a trend of greater improvement in the behavioral group. Resultssuggest that nonpharmacological treatment has a lesser impact on menstrually associated headachesthan on headaches not associated with menstruation.

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