Two studies; Menstrual migraines: more severe but treatable.(Gynecology)

Menstrually associated migraines tend to be more severe than attacks that occur at other times of the month, an observational study has shown.

In addition, the intensity and duration of menstrual migraines can be mitigated in some women through prophylactic treatment with frovatriptan (Frova), according to the results of a second study.

Menstrual migraine is defined as migraine headache that occurs regularly between 2 days before and the first 3 days of menstrual bleeding, said Dr. Anne MacGregor of St. Bartholomew's Hospital in London and lead author of one of the studies (Neurology 63[2]:351-53, 2004).

Dr. MacGregor and her colleagues analyzed the migraine patterns of 155 women seeking treatment at the City of London Migraine Clinic. All of the women in the study tracked at least two menstrual cycles, and nearly half of the women tracked four or more menstrual cycles. The investigators used the information on each woman's self-report card to ascertain whether the patient had experienced a headache or a migraine.

Only those women who were not using hormonal contraception were considered in the analysis.

The likelihood of experiencing a migraine attack was 25% higher in the 5 days preceding menstruation and 71% higher in the 2 days preceding menstruation than at other times of the month. In addition, severe attacks were more likely to occur during the 5 days prior to and the 5 days following menstruation, compared with all other times of a woman's cycle, and women were almost five times more likely to have a migraine associated with vomiting on or during days 1-3 of menstruation.

In a multicenter, placebo-controlled, randomized trial, Dr. Stephen D. Silberstein of Thomas Jefferson University in Philadelphia and his associates found that frovatriptan may be a ...