Migraine or PMS?
Premenstrual syndrome (PMS) affects three out of every four menstruating women to some degree. For some, it takes the form of feeling tense and craving chocolate. For others, it is considerably worse and may entail mood swings, anger, sadness, difficulty concentrating, insomnia, fatigue, bloating, weight gain, joint pain, and tender breasts. One of the most common symptoms is having headaches.
A migraine is a specific type of headaches characterized by intense, throbbing pain, nausea, and sensitivity to light and sound. For many people, any physical activity can worsen symptoms, and a migraine can be completely incapacitating. Migraines occur more often in women than in men, and it seems hormones may play a role.
The Link Between Hormones and Headaches
Migraines usually begin in the early teenage years, and many girls will have their first migraine in conjunction with their first period. Many women who have migraines, about two-thirds or so, will notice that they get worse during or right before menstruation. Researchers believe that this is due to the drop in estrogen that occurs around this time. Estrogen is a sex hormone involved in regulating the monthly reproductive cycle. Circulating levels of estrogen seem to correspond to serotonin levels in the brain. Serotonin is a neurotransmitter involved in regulating many of the basic processes of living such as sleeping, eating, sexual arousal, and mood. Many of the symptoms of PMS can be put down to low serotonin levels. In addition, serotonin also regulates pain sensitivity. Low serotonin, and hence, low estrogen, can make women more sensitive to pain and more likely to develop headaches. This may be how hormonal fluctuations can cause migraines before and during menstruation.
So far, there is no specific treatment available for migraines related to menstruation. In addition, these migraines are often the hardest to treat and the least responsive to conventional medications. For some women, taking low dose birth control to control their monthly cycle can help prevent migraines and reduce the severity of those that do occur. For others, however, taking birth control can actually trigger migraines. If you think that your birth control may be triggering migraines, talk to your doctor about switching to another brand or taking a kind of hormonal birth control without monthly placebo pills, since these are often more helpful. For many women, over-the-counter pain relievers, especially non-steroidal anti-inflammatories such as naproxen and ibuprofen, can effectively treat the symptoms. In some cases, this may not be enough, and stronger prescription medications may be required. Sometimes, taking preventive medications for a few days prior to menstruation can prevent the onset of a migraine. Consult with your doctor about what treatment options will work best for you. Finally, simple lifestyle changes such as eating a healthy diet, exercising frequently, keeping a regular sleep schedule, using relaxation techniques to reduce stress, and identifying and avoiding migraine triggers can be very helpful to many women.
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