Here we are going to share information on the topic “9 Best Triptans for menstrual migraine.” Menstrual migraines, often known as migraines associated with menstruation, can be extremely painful. As the days pass and your period approaches, you not only endure agonising pain every month but also live in constant fear and anxiety of an imminent migraine attack.
Menstrual migraine attacks are sometimes referred to as hormonal headaches since it is believed that these episodes are caused by variations in hormone levels that happen around that time of the month.
Nada Hindiyeh, MD, a headache specialist and researcher at Stanford Health Care in Palo Alto, California, states, “We believe the decline in oestrogen is the reason for the frequent migraine attacks that women experience around their menstrual cycle. “The onset of the cycle is a major migraine trigger.”
Contrasting Menstrually Related and Menstrual Migraine
- Menstrual migraine, to put it simply, is a subtype of migraine that occurs when a person experiences migraine episodes only throughout their menstrual cycle, according to Dr. Hindiyeh.
- In addition, there is menstrually associated migraine, which implies that in addition to migraine attacks during your monthly cycle, you may also experience them at other times of the month, according to Hindiyeh.
- According to Hindiyeh, menstrually associated migraines account for the majority of migraine attacks experienced by women around menstruation. Hindiyeh states, “They have other triggers or other times when they’ll experience migraine [attacks], but their menstrual cycle will surely be a trigger.”
Treating Menstrual Migraine Can Be Difficult
- The most difficult types of migraines to manage are those that are menstrual or menstrually associated. According to her, “[Attacks] can be fairly severe, linger for several days, and be quite debilitating.”
- According to Hindiyeh, migraine attacks can occur anywhere from five days a month to more for many women, even if they only occur during their menstruation. “If so, it’s definitely time to discuss daily preventive therapy alternatives for migraine with your doctor,” she advises.
According to Hindiyeh, there are generally a lot of therapeutic options for menstrual migraine and migraine prevention. The most effective drugs and lifestyle changes to lessen the frequency and intensity of menstrual and menstruation-related migraine attacks are listed below.
9 Best Triptans for menstrual migraine
1. Triptans May Be Used as a Preventive Measure
- According to Migraine Again, triptans are acute drugs that are used as soon as a person senses that a migraine attack is about to happen.
- However, according to Hindiyeh, some triptans have a longer half-life, which makes them effective in preventing or lessening migraine attacks.
- “The half-lives of your shorter-acting triptans, including rizatriptan (Maxalt) and sumatriptan (Imitrex), are usually four hours or less,” she says. According to a StatPearls article, a drug’s half-life is the amount of time needed for its concentration in the body to drop to half of its initial dose
- Longer, half-lived triptans are also available. For instance, the half-life of naratriptan (Amerge) is six to eight hours, while that of frovatriptan (Frova) is 26 hours. Around the time of your menstruation, these longer-acting ones can frequently be used as a “mini-prophylaxis,” according to her.
- If you are aware that having your period usually sets off a migraine attack, you can begin taking one of those longer-acting triptans on a regular basis a few days prior to your period. Depending on the prescription, you may take it once daily or twice daily for a few days in a row. According to Hindiyeh, this can help stop the migraine episode from getting worse.
- Frovatriptan is especially advised by the American Headache Society “for short-term prophylactic therapy of menstrual migraine.”
2. An Additional Prevention Option Is NSAIDs
- Similar to triptans, nonsteroidal anti-inflammatory medications, or NSAIDs, such as naproxen (Aleve), can also be strategically used as a prophylactic for menstrual migraine.
- Menstrual migraine has been successfully prevented by taking 550 milligrammes (mg) of Aleve twice a day for six days prior to and seven days following menstruation, according to headache specialist Vincent T. Martin, MD, writing for the American Headache Society.
- After reviewing 15 studies comparing NSAIDs and complementary medicines, including several herbal remedies, a meta-analysis published in Neurology came to the conclusion that NSAID use is “probably helpful” in preventing episodic migraine attacks. However, there was no discussion of their specific application in preventing menstrual migraines.
- Talk to your healthcare provider about this approach if you believe you might want to try taking an NSAID to prevent menstrual migraine attacks. According to the U.S. Food and Drug Administration, consuming NSAIDs may increase your risk of heart attack and stroke, as well as ulcers and gastrointestinal bleeding.
3. Oral Contraceptives May Decrease the Frequency of Menstrual Migraines
- According to Hindiyeh, there is some evidence that various oral contraceptive pill types can actually lessen the frequency of monthly migraines and migraines associated with menstruation.
- As not all forms of oral contraception fall under this category, Hindiyeh advises you to discuss your options with your gynaecologist, primary care physician, or neurologist. “Some will prevent excessive fluctuations in your oestrogen levels,” she explains.
- Tell your healthcare practitioner about your migraine history if you’re thinking about taking oral contraceptives, often known as the pill, as a birth control method or to try to reduce your migraine symptoms, advises Hindiyeh.
- Although the majority of headache experts concur that hormonal birth control is safe for the majority of migraine-affected women, the American Migraine Foundation notes that there are certain situations in which it may increase the risk of stroke, cardiovascular disease, or deep vein thrombosis (blood clot).
- It is especially recommended that women with migraine auras discuss any extra-risk factors for stroke or cardiovascular disease with their doctors.
4. Self-Care Affects the Frequency of Migraines
- According to Hindiyeh, it’s crucial to look after yourself and make an effort to reduce stress if you suffer from menstrual migraines.
- Maintain a regular sleep schedule by waking and sleeping at roughly the same times each day. Avoid skipping meals, make an effort to get protein in each meal, and spend 20 to 30 minutes each day engaging in aerobic exercise, advises the speaker.
- You can lessen the frequency and intensity of your migraine attacks by prioritising these habits, advises Hindiyeh.
5. Magnesium Taken Every Day Has a Preventive Impact
- “As a natural medication to take daily to help prevent menstrual migraines, I really prefer magnesium,” Hindiyeh explains. Although the exact mechanism of action—that is, the “why” behind how magnesium relieves migraines—is still unknown, she notes that there is evidence to support its use. “At this stage, it’s all theoretical. It might be reducing hyperexcitability, neuronal firing, or stabilising cells,” she continues.
- High dosages of magnesium citrate “appear to be a safe and cost-efficient strategy,” according to a review that looked at five clinical studies of the drug for the prevention of migraines and was published in the February 2018 issue of Headache.
- The American Migraine Foundation notes that taking a daily oral magnesium supplement has been demonstrated to be beneficial in preventing menstrually linked migraine, particularly in women who have premenstrual migraine. However, the headache review did not directly address menstrual migraine.
- Magnesium supplements are available over-the-counter in a range of forms. On the website for migraine, you may find out more about the different kinds. Once more, keep in mind that discussing any supplements you take or would like to take with your doctor is always a good idea.
6. Consistent Exercise Helps Avoid Menstrual Migraines
- According to Hindiyeh, “I appreciate it when people opt to make lifestyle alterations that can really make a difference when we consider all the measures to prevent migraine attacks.”
- According to Hindiyeh, there is a wealth of research that suggests regular aerobic exercise alone can be an effective preventive measure. Additionally, several studies have suggested the potential benefits of yoga and high-intensity interval training (HIIT).
- Numerous studies have demonstrated that aerobic exercise can reduce migraine frequency, intensity, and duration (with higher-intensity exercise having greater effects), according to a review published in 2020 in Current Pain and Headache Reports. However, the author noted that low-impact workouts like yoga might also be advantageous.
- Some individuals find that regular exercise not only helps avoid migraine episodes, but that a quick workout can really help ease a slight headache, according to Hindiyeh.
- However, she adds that exerting too much of yourself can set off a migraine, particularly if you are already experiencing one.
- The ability of regular activities to exacerbate migraine symptoms is one of the disease’s defining characteristics. Moving around a lot will definitely make your migraine worse, so it’s probably not the best time to jog or engage in other cardiovascular exercise if you’re experiencing a severe attack, according to Hindiyeh.
7. Migraine Attack Prevention with Beta-Blockers
- It’s possible that beta-blockers are most commonly used to treat excessive blood pressure and other cardiovascular issues. However, Hindiyeh adds that they can also be used to prevent migraine attacks in general, not only menstrual migraines.
- Propranolol is one of the beta-blockers that is frequently taken as a daily prophylactic measure for migraines. Numerous pieces of evidence point to their potential to lessen migraine frequency and intensity, according to her.
- A review published in the journal Neurotherapeutics in April 2018 said that it is unclear exactly how beta-blockers stop migraine attacks. The primary reason for this could be their ability to obstruct the actions of the hormones norepinephrine, also known as noradrenaline, and adrenaline, which relax blood vessels and slow the heart.
- It might also have to do with how some beta-blockers inhibit specific serotonin receptors in the body, including the brain. Attacks caused by migraines have been related to changes in serotonin levels in the brain. However, beta-blockers have a wide range of additional physiological effects; these are only two potential uses for them as migraine treatments.
- The beta-blockers metoprolol (Lopressor), propranolol, and timolol “have established efficacy and should be offered for migraine prevention,” according to a position statement from the American Headache Society, while Tenormin (atenolol) and Corgard (nadolol) “are probably effective and should be considered for migraine prevention.”
- Hindiyeh notes that if beta-blockers aren’t an option for you or don’t lessen the frequency of your migraine attacks, there are a number of other drug groups that can be useful preventives, such as anti-epileptic medications and some antidepressants.
8. CGRP Inhibitors May Help with Periodic Migraine
- Among the newest medications authorised for the treatment of migraines are CGRP inhibitors. Two varieties exist: CGRP monoclonal antibodies, which are administered as injections or infusions and are used to prevent migraines; and CGRP receptor antagonists, which are taken as pills and, depending on the product, are either used for acute therapy or preventive. They are both directed toward calcitonin gene-related peptide (CGRP), a pain-transmission protein.
- Few trials have examined the efficacy of these medications in treating or preventing menstrual migraine, however a recent investigation using CGRP monoclonal antibodies produced encouraging findings.
- According to a December 2021 publication in the journal Pain and Therapy, 40 women received six months of injections of the monoclonal antibody CGRP. The majority of individuals used erenumab (Aimovig), while some also used fremanezumab or galcanezumab (Emgality) (Ajovy).
- Six months later, the incidence, duration, and intensity of migraine attacks that occurred within the perimenstrual window—which is defined as two days prior to the commencement of menstruation and extending through three days following onset—were significantly reduced, according to the study. Furthermore, a significantly higher proportion of the study’s female participants responded to migraine medications within two hours of taking them.
- Menstrual migraine “may constitute a safe and effective preventive treatment strategy,” the researchers stated in reference to CGRP monoclonal antibodies.
- Hindiyeh warns, nevertheless, that unless a migraine sufferer has tried a number of oral preventive drugs without success, most insurance companies will not cover a CGRP treatment.
- Furthermore, she states, “I would advise avoiding certain CGRP antibodies, notably Aimovig, in anyone who has hypertension or constipation, as it may make these issues worse.”
9. One Possible Option Is Nerve Stimulation
- It might be worthwhile for women to use nerve stimulation devices as an alternative to prescription drugs. Five such gadgets are authorised for the treatment of migraines; some are solely for acute care, while others are for both acute and preventive care.
- The GammaCore device, which stimulates the vagus nerve via the neck, has been shown in at least one study to have a prophylactic, or preventive, effect on menstrual and menstrually related migraine when used daily beginning three days before the expected onset of menstruation and ending three days after the end of menses. However, most have not been specifically studied for menstrual migraine.
- When the gadget was used, the number of migraine days per month and the amount of analgesics used decreased significantly (pain relievers).
9 Best Triptans for menstrual migraine
In conclusion, a variety of parameters, including effectiveness, tolerability, and individual reaction, must be taken into account while selecting the optimum triptan for menstrual migraines. Effective migraine management requires not only identifying the best triptan for individual requirements and circumstances—of which there are many—but also speaking with a healthcare provider.
Frequently asked questions
9 Best Triptans for menstrual migraine
What is the drug of choice for menstrual migraines?
Answer: Transdermal oestrogen patches or gel, triptans, and NSAIDS are examples of short-term preventive treatments. Menstrual migraine can be prevented with naproxen sodium at a dose of 550 mg BID given six days prior to or seven days following menstruation.
What is the best thing to take for hormonal migraines?
Answer: The standard treatment for a menstrual migraine is nonsteroidal anti-inflammatory drugs (NSAIDs). The NSAIDs Ketoprofen (Orudis®) and other are most frequently used for menstrual migraines. Ibuprofen (Motrin and Advil®)
Is triptan used for menstrual migraines?
Answer: Both monthly and non-menstrual migraines can be effectively treated acutely with serotonin 5-HT(1B/1D) receptor agonists, or triptans. A triptan should be started as soon as possible as acute therapy, while the headache is still quite mild.
Which triptan works fastest?
Answer: The beginning of action of subcutaneous sumatriptan is the fastest. The standard starting dose of subcutaneous sumatriptan for acute migraine is 6 mg. If necessary, the dose can be given again after an hour.
Why do periods trigger migraines?
Answer: Menstrual migraine has been related to the normal decline in oestrogen levels that occurs before to the onset of your period. Higher amounts of prostaglandin, another hormone that has been linked to menstrual migraines, are found in women who have painful and heavy periods.
Is migraine a symptom of hormonal imbalance?
Answer: A multitude of symptoms may be triggered by your hormones when something even slightly goes awry. A common sign of hormone imbalances are migraines and headaches. The relationship between hormones and migraines is explained by Kimberley Shine, MD of Shine Health and Wellness, a specialist in both brain health and hormones.