|April 2010 · Vol. 22, No. 04
The gynecologist’s role in managing menstrual migraine
Your expertise in manipulating the hormonal underpinnings of this pervasive complaint may be the missing link in treating it successfully
Menstrual migraine is a migraine without aura that occurs in predictable association with menses
Leuprolide acetate markedly diminished menstrual migraine in women who seldom experienced headaches other than their menstrual attacks
Extended OC regimens that forego monthly withdrawal bleeds can provide a lengthy reprieve from menstrual migraine
Dr. Calhoun is a founder of the Carolina Headache Institute in Chapel Hill, NC.
Dr. Calhoun has received research support from GlaxoSmithKline and Teva Pharmaceuticals. She is a consultant to Merck, Teva, and MAP Pharmaceuticals, and a speaker for GlaxoSmithKline and Merck.
A busy gynecology practice sees more migraineurs in a day than a neurology practice sees in a month. But most of the migraineurs who visit gynecology offices have a chief complaint other than headache, and most leave without having mentioned the migraine—returning home to continue treating themselves with the same remedies their mothers used. Many of these women fail to seek a specific diagnosis, or treatment, until they develop chronic daily headaches or become unable to work.