Headache Medicine and Women's Health Series: Menstrual Migraine

Dr. Tesha Monteith discusses menstrual migraine and treatment options.

Show transcript:

Dr. Tesha Monteith:

This is Tesha Monteith with the Neurology Minute. Welcome back to our series on headache medicine and women's health. I'm continuing our discussion on menstrual migraine, and I want to focus on treatment. We talked about increasing the yield of diagnosis for menstrual migraine, but what are the best ways to treat our patients? I think there are two broad categories we can think about:

We can think about non-hormonal methods or hormonal methods. The non-hormonal methods include a combination of abortive therapies, as well as preventative therapies that can be used for a mini prophylaxis, as well as when patients have a higher burden of overall migraine, considering the general highly effective preventive therapies.

Common mini prophylaxis include triptans such as Frovatriptan, Naratriptan, and Zolmitriptan when used twice per day. Nonsteroidal anti-inflammatories can be used for five to seven days around menses, such as naproxen, 550 milligrams twice per day. Magnesium, 360 milligrams daily or higher, can also be started mid-cycle, so day 15, towards menstruation.

Although considered off-label, gepants, ubrogepant, as well as rimegepant, can also be used during the susceptible window.

This is Tesha Monteith. Thank you for listening to the Neurology Minute.