Menstrual Migraines are Migraine which occur during a woman’s menstrual cycle. These can be split into two types - Pure Menstrual Migraines and Menstrual Related Migraines. The difference between them is when in the cycle they occur.
Pure Menstrual Migraines are less common than Menstrual Related Migraines. They occur during menstruation - 1-2 days before through to 3 days following onset of flow.
When Migraines occur outside of the menses they are classified as Menstrual Related Migraines. This is the most common form of Menstrual Migraine.
Symptoms of both Pure and Menstrual Related Migraines are unilateral throbbing head pain without aura (typically). Head pain can alternate sides within or between an episode. Menstrual Migraines often last longer in duration than other types of Migraines and have been classified as one of the top 5 disabling conditions for women.
Oestrogen levels have been linked to Menstrual Migraines. Many women experience Migraines around day one of their cycle (when oestrogen levels are lower), and mid cycle during ovulation(when oestrogen levels are higher).
These fluctuations in oestrogen are normal and hormone mapping of females with menstrual migraines have been shown to be no different to those without Menstrual Migraines.
Fluctuations of normal oestrogen levels in the body are being misinterpreted by an underlying disorder in the central nervous system - which has been identified as a sensitised brainstem.
Normal fluctuations in oestrogen are passed through the sensitised brainstem which exaggerates the signal (like a loudspeaker turned up to full blast). This signal is sent to the brain and perceived as a noxious event and head pain results.
Triptan medication is commonly used to treat migraines. Triptans desensitise the brainstem temporarily. Unfortunately, its use does not prevent recurrences. For this the cause of the brainstem sensitivity needs to be addressed.
Because of their close relationship to the brainstem - the muscles, joints, ligaments of the upper cervical spine must be examined as a potential source of the sensitisation of the brainstem. This needs to be done by a skilled practitioner who has special training in the examination of this area to confirm or rule out an underlying upper neck disorder.