Women who have noticed a correlation between migraines and their monthly period now have scientific evidence to support the connection. They also may have hope for a preventative medicine.Two separate studies published in the July 27, 2004 issue of Neurology dealt with the issue of menstrual migraines. The first confirmed the higher likelihood of migraines near the beginning of menstruation, while the second showed that frovatriptan may reduce the severity or frequency of menstrual migraines. Although women have been reporting the menstruation-migraine connection to their doctors for years, this may be the first published study to establish this link with scientific data.
Dr. Anne MacGregor, a London doctor, published the results of her study at the City of London Migraine Clinic. She and other researchers analyzed the headache diaries of 155 women. None of the women were taking birth control or any other hormone therapy. The patients were asked to note the incidence and severity of their migraines as well as the timing of their periods for three months.
The researchers found that headaches were most common on the first day of menstruation, occurring twice as often then as during the rest of the month. Women were 71% more likely than average to have migraines during the two days before getting their periods and 25% more likely to get a migraine in the five days preceding menstruation. The migraines were also more severe just before and just after menstruation. Risk of migraine was much lower near ovulation.
The second study was authored by Dr. Stephen D. Silberstein of Thomas Jefferson University in Philadelphia. For six days before and during their period, 443 patients around the United States were given a placebo, 2.5 mg frovatriptan daily, or 2.5 mg frovatriptan twice daily. This process was repeated for three menstrual cycles.
Two-thirds (67%) of patients taking a placebo got menstruation-associated migraines. Those who used frovatriptan were less likely to get a migraine—52% of the group receiving once-daily medication got migraines, and only 41% of the twice-daily medication group suffered from menstruation associated migraines. In addition, those who took frovatriptan also reported that their migraines were less severe, shorter, and required less additional medication than those who took a placebo.
Frovatriptan is not appropriate for women with cardiovascular disease or uncontrolled hypertension. Some health insurers may not be willing to pay for this treatment.
Women are three times more likely to suffer from migraines than men, and the condition affects nearly one in five women. For years, women have told doctors of the correlation between severe migraines and menstruation, but previous research, including a 2000 study by Dr. Silberstein, has not affirmed this. Now the connection has been confirmed.
Dr. Silberstein’s study was funded by Vernalis, Ltd., makers of frovatriptan. Dr. MacGregor’s study was funded by the Migraine Action Association and the Golden Charitable Trust.
