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.
Menstrual Migraine: Case Studies of Women with Estrogen-Related Headaches
Article first published online: 19 NOV 2008
© 2008 the Authors. Journal compilation © 2008 American Headache Society
Headache: The Journal of Head and Face Pain
Special Issue: Identify the Menstrual Migraineurs in Your Practice: A practical case-based approach
Volume 48, Issue Supplement s3, pages S131–S141, November/December 2008
How to Cite
Hutchinson, S. L. and Silberstein, S. D. (2008), Menstrual Migraine: Case Studies of Women with Estrogen-Related Headaches. Headache: The Journal of Head and Face Pain, 48: S131–S141. doi: 10.1111/j.1526-4610.2008.01311.x
- Issue published online: 19 NOV 2008
- Article first published online: 19 NOV 2008
- Accepted for publication October 8, 2008.
- Menstrual Migraine;
- estrogen-related headaches;
This paper presents 2 case scenarios that illustrate the complexity of diagnosing and managing migraine associated with hormonal changes. Migraine is commonly associated with comorbidies such as depression, anxiety, obesity, cardiovascular disease, as well as other conditions, thereby making management more challenging for the physician and the patient. The first case is a 35-year-old woman who has migraine almost exclusively during menstruation. She is under a physician's care for long-term management of premenstrual dysphoric disorder (PMDD). Achieving a differential diagnosis of pure menstrual migraine is illustrated, and a detailed treatment plan including use of a migraine miniprophylaxis protocol, management of her PMDD, and prescription of acute treatment medications is reviewed. The second case scenario describes the diagnosis of menstrually associated migraine in a woman who suffers from a frequent disabling migraine along with work-related anxiety and depression. This paper reviews her differential diagnosis, laboratory testing, treatment plan, including management of her comorbid anxiety and depressive symptoms.