This is the 4879th article of Da Yi Xiao Nursing
In the days of the month, there are always many people who have headaches, accompanied by abdominal pain and lower abdominal distension, and in severe cases, they are even unable to work or study, what is the reason for this? Today we will talk about menstrual migraine.
1. What is menstrual migraine and how to classify it?
Migraine attacks in menstruating women, with at least two episodes in a continuous menstrual cycle of at least 3 months, are called simple menstrual migraine, which can be divided into two types according to the presence or absence of aura: simple menstrual migraine without aura and simple menstrual migraine with aura. By menstruation, we mean endometrial bleeding caused by the withdrawal of exogenous progesterone caused by the use of combined oral contraceptives or cyclic hormone replacement therapy, which includes 1-2 days before menstruation to days 1-3 of menstruation. If there is a headache attack at other times of the menstrual cycle, we call it menstruation-related migraine, and there are two types of migraine based on the presence or absence of aura: menstruation-related migraine without aura and menstruation-related migraine with aura.
Why do we have so many detailed types of menstruation-related headaches? The significance of distinguishing between simple menstrual migraine and menstruation-related migraine is that hormone prophylaxis may be more effective for the former.
2. How to treat menstrual migraine?
1. Non-drug treatment
Similar to other types of migraine treatment, non-pharmacological treatments are the cornerstone of all treatments.
Patient education should be carried out throughout the migraine process. First of all, it can help patients keep a headache diary, identify the triggers of migraine attacks, evaluate the efficacy, follow up regularly and adjust the intervention plan in a timely manner. At present, there are paper versions of headache diaries, as well as some electronic versions of headache diaries, and various small program APPs are also under development, and it is believed that they will be popularized in the near future. Secondly, develop a healthy lifestyle, such as regular exercise and rest, limit red wine intake, and avoid various triggers. Finally, it is necessary to establish a reasonable treatment expectation, that is, to know the fact that there is no cure for migraine at present, but it can be effectively controlled, that is, the frequency of attacks, the severity of headaches, the duration of headache attacks, and the reduction of disability can be reduced through treatment. Behavioral therapy and mindfulness therapy can also be considered, mainly including relaxation training, biofeedback, and cognitive behavioral therapy, which can be used as adjunctive treatments.
2. Medication
Acute treatment can be treated with classic medications, including acetaminophen, non-specific drugs (NSAIDs) (eg, ibuprofen, diclofenac, naproxen, aspirin), and their combinations. Specific drugs include triptans such as zolmitriptan, rizatriptan, sumatriptan, eletriptan, frotriptan, naratriptan, and amotriptan, and CGRP receptor antagonists such as ubudgepam, remecepam, atogizpam, and zavigepam. Some of these new therapeutic drugs have not yet been marketed in China, and some have just been used in China, so it is recommended to go to the neurology headache clinic to find a professional headache specialist for diagnosis and treatment.
Because of the particularity of menstrual migraine, hormone prophylaxis therapy can be considered for simple menstrual migraine, and the dosage and frequency of drugs are different according to different ages, so it is better to consult a professional gynecologist in gynecology.
Menstrual headache is still a relatively common headache for girls, and I hope this small article can provide you with some help and keep you away from menstrual headaches.
Department of Neurology, The Second Hospital of Jilin University
Written by: Zhu Bochi, attending physician
Review: Man Yuhong, Chief Physician
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