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Prevalence of migraine on each day of the natural menstrual cycle
An association between migraine and menstruation has been reported by 50% of women, with many women reporting that menstrual attacks are more severe, last longer, and respond less well to treatment compared with non-menstrual attacks.
Most research into the clinical association between migraine and menstruation has involved small numbers of women over few cycles, and comparing menstrual and non-menstrual attacks within the total population, not within the same person. This new study was undertaken to assess the association between migraine and menstruation within the same woman.
The analysis of 155 women over 693 cycles showed that menstrual attacks tended to be more severe and associated with nausea and vomiting compared with attacks at other times of the cycle. The greatest effects of menstruation on migraine was during the first 3 days of the cycle. Compared with all other times of the cycle, migraine was 1.7 times more likely to occur during the 2 days before menstruation and 2.1 times more likely to be severe. It was 2.5 times more likely to occur during the first 3 days of menstruation and 3.4 times more likely to be severe. Women were almost 5 times more likely to have a migraine associated with vomiting on or during days 1 to 3 of menstruation.
This confirms that migraine at menstruation is different from non-menstrual attacks, even within individuals.
E. Anne MacGregor, MFFP; and Allan Hackshaw, MSc. - Neurology, July 2004.