None of these treatments suit everyone, so you may need to try more than one to find something that suits you best. It is worth the effort, though. Your headaches are unlikely to go away by themselves and life is better without headaches.
Headaches with periods
A headache that comes each month with a period often improves with one of these options:
- A iucd in the uterus
- A diclofenac 100mg suppository
- A ‘triptan’ nasal spray available from your doctor, or,
- An estrogen hormone patch used at period time
A low grade headache for several days each month
Sometimes they may be severe, while at other times just a nuisance. It is definitely worthwhile trying a preventer medication taken every day. Helpful medications in young women include:
- Amitriptyline 5-25mg 3 hours before bed each day
- Cyproheptadine (Periacten), 2 to 4mg each night
- Other medications from your doctor, or explained in our book
Try each one for 2-3 months and keep a headache diary, so you can decide if it has helped.
Migraines at other times
Make a plan with your doctor and ask about a ‘triptan’ nasal spray.
There is much more information on headaches in our book, and at www.migraineclinic.org.uk
Unfortunately, this has led to some women having drastic hormonal and gynaecological manipulation, generally with poor results. For most patients, hormonally related migraine is still best treated in a conventional manner using the types of migraine treatment for most patients. However, in certain cases collaboration between a headache specialist and a gynaecologist can produce the best results. For some women with migraine, the attacks are very much more likely to occur around the beginning of the period than at other times and this is called menstrual migraine. It seems to be triggered by the drop in the blood levels of the female hormone oestrogen at around the time of the period. This can be partly helped by hormonal treatment which may include the oral contraceptive but needs to be done carefully as it also may make the condition worse. It is not clear why headache may be more common in patients with chronic pelvic pain. However, current research at the University of Adelaide suggests that there is a low grade of inflammation in the brain which predisposes to chronic pain and these can drive both chronic pelvic pain and headache. It is possible that treatment directed at this mechanism might help both conditions.