From the Guidelines
For menstrual migraine, the most effective treatment approach is to initiate perimenstrual preventive treatment with a long-acting NSAID, such as naproxen, or a triptan, such as frovatriptan or naratriptan, for 5 days, beginning 2 days before the expected first day of menstruation 1. This approach is supported by recent guidelines that suggest the use of preventive treatment for menstrual migraine, which can help reduce the frequency and severity of headaches. Some key points to consider when treating menstrual migraine include:
- The use of NSAIDs, such as naproxen, which can be started 1-2 days before the expected period and continued through the first few days of menstruation 1
- The use of triptans, such as frovatriptan or naratriptan, which can be used specifically for migraine-type headaches 1
- The potential benefits of hormonal treatments, such as continuous or extended-cycle birth control pills, which can help reduce hormone fluctuations that trigger headaches 1
- The importance of staying hydrated, maintaining regular sleep patterns, and managing stress to complement medication approaches It's also important to note that some women may benefit from continuous use of combined hormonal contraceptives, but this approach is contraindicated in women with migraine with aura, due to the increased risk of stroke 1. In terms of specific medications, naproxen is a recommended option, with a dosage of 550mg twice daily, starting 2 days before the expected period and continuing through the first few days of menstruation 1. Additionally, frovatriptan and naratriptan are also recommended options, with a dosage of 2.5mg and 1mg respectively, taken as needed 1. It's essential to consult with a healthcare provider to determine the best course of treatment for individual cases of menstrual migraine, as some women may require combination therapy or preventive medications 1.
From the FDA Drug Label
NSAID medicines are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as: different types of arthritis menstrual cramps and other types of short-term pain
The medication used to treat menstrual migraine is Naproxen, an NSAID, which is used to treat pain and inflammation, including menstrual cramps. 2
- Key points:
- Naproxen is used to treat menstrual cramps and other types of short-term pain.
- It is an NSAID with analgesic and antipyretic properties.
- The exact mechanism of action is not completely understood but may be related to prostaglandin synthetase inhibition. Note that while naproxen is used to treat menstrual cramps, the provided drug labels do not explicitly mention its use for menstrual migraine. However, given its use for menstrual cramps and other types of short-term pain, it can be inferred that naproxen may be used to treat menstrual migraine.
From the Research
Medications for Menstrual Migraine
The following medications are used to treat menstrual migraine:
- Triptans, such as sumatriptan, rizatriptan, naratriptan, zolmitriptan, and almotriptan, which are effective for acute treatment of menstrual migraine 3, 4, 5, 6, 7
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen sodium, which can be used for acute treatment and short-term prevention of menstrual migraine 4, 6, 7
- Ergot derivatives, such as ergotamine tartrate, which can be used for acute treatment and prevention of menstrual migraine 4
- Estrogen therapy, which can be used to prevent menstrual migraine by maintaining a sustained level of estrogen 4, 6, 7
- Magnesium supplementation, which has been shown to be effective for short-term prevention of menstrual migraine 6, 7
- Continuous combined hormonal contraceptives (CHCs), which can be used to prevent menstrual migraine, but are not recommended for women with a history of menstrual migraine with aura 3
Treatment Options
Treatment options for menstrual migraine include:
- Acute treatment with triptans or NSAIDs 3, 4, 5, 6, 7
- Short-term prevention with triptans, NSAIDs, or estrogen therapy 4, 6, 7
- Daily prevention with continuous hormonal contraceptives or anti-epileptic medications, such as topiramate or lamotrigine, although caution is advised when using these medications with oral contraceptives or hormonal treatments 3, 7