Diagnosis and Treatment of the Menstrual Migraine Patient

Authors

  • Stephen D. Silberstein MD, FACP,

    1. From the Thomas Jefferson University, Philadelphia, PA, USA (S.D. Silberstein); Orange County Migraine and Headache Center, University of California, Irvine, CA, USA (S.L. Hutchinson).
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  • Susan L. Hutchinson MD

    1. From the Thomas Jefferson University, Philadelphia, PA, USA (S.D. Silberstein); Orange County Migraine and Headache Center, University of California, Irvine, CA, USA (S.L. Hutchinson).
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  • Conflict of Interest: Susan L. Hutchinson, MD has received honoraria from GlaxoSmithKline and Ortho-McNeil and is on the advisory board of GlaxoSmithKline. Stephen D. Silberstein, MD, has received research grant support from Abbott Laboratories, Advanced Bionics Corporation, Advanced Neuromodulation Systems, Inc., AGA, Allergan Inc., AstraZeneca, Endo Pharmaceuticals, GlaxoSmithKline, Eli Lilly and Company, Medtronic, Inc., Merck & Co., Inc., Ortho-McNeil, Inc., Pfizer Inc., Pozen Inc., ProEthic, Valeant Pharmaceuticals, and Vernalis plc; is on the Speaker's Bureau for AstraZeneca, GlaxoSmithKline, Merck & Co., Inc., Ortho-McNeil, Inc., and Pfizer Inc.; and is an Advisory Board Member for Allergan Inc., Endo Pharmaceuticals, GlaxoSmithKline, Medtronic, Inc, Merck & Co., Inc., Ortho-McNeil, Inc., Pfizer Inc., Pozen Inc.,and Valeant Pharmaceuticals.

S. Silberstein, The Jefferson Headache Center, Gibbon Building, Suite 8130, 111 South Eleventh St., Philadelphia, PA 19107, USA.

Abstract

Women presenting with recurrent disabling headache frequently have migraine; but physicians need to rule out other headache disorders before they reach a diagnosis of migraine with or without aura. Many women who experience migraine in close association to their menstrual cycle may meet the diagnostic criteria for either menstrually related migraine (MRM), or pure menstrual migraine (PMM). Once an accurate diagnosis is made, treatment may be established to best suit the individual needs of that patient. Most women will find that migraine associated with hormone fluctuations respond well to standard treatment approaches including pharmacological and nonpharmacological treatments. Pharmacological approaches include acute, preventive, and short-term prophylaxis. Herein we review the difference between non-menstrual migraine, PMM, and MRM and identify effective treatment strategies for appropriate management of migraine associated with hormonal fluctuations.

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