A majority of the migraine attacks are accompanied by headache, which is an intense, throbbing or pounding pain involving one temple. At times, the pain may be located in the forehead or around the eye or the back of the head. Usually, migraine attack reoccurs and is a chronic disability. The headache is generally on one side of the head, though it may rarely happen on both the sides. The unilateral headache changes sides alternatively, from one attack to another, which is, in fact, characteristic of migraine (otherwise it may be a more serious problem).
Daily routines like walking upstairs aggravate a migraine headache. The most common and obvious symptoms of migraine are nausea, vomiting, or sensitivity to light. Some people experience warning symptoms called aura before the actual beginning of a headache. An aura is a group of symptoms, mainly a vision disturbance which foretells that a headache is coming. But, most of the people do not have such warning signs. In fact, migraine headaches are classified based on their symptoms such as migraine without aura, migraine with aura and mixed tension migraine.
Migraine without aura: The most common symptoms can be a throbbing pulsating headache, which is usually worse on the sides of the forehead, generally only on one side, that can be either severe or dull, lasting for six to forty eight hours. The other symptoms are dizziness, vertigo (a feeling that the room is moving), loss of appetite, fatigue and nausea. There may be symptoms after a migraine attack too. It can be dullness, neck pain and a need for more sleep. Such symptoms may be accompanied apart from headache.
Migraine with aura: Before the headache, the warning symptoms may occur anywhere from a few minutes to 24 hours and the aura or vision changes happen in one or both the eyes. The symptoms may be one or more of the following; seeing zigzag lines, seeing flashing lights, temporary blind spots, sensitivity to bright light, visual hallucinations, blurred vision and eye pain. Accompanying the headache, there are other symptoms like loss of appetite, chills, increased urination, increased sweating, irritability and fatigue. The "pounding" headache starts on one side and spreads to the other side that typically starts as a dull ache and progressively worsens over several minutes to hours. So, the patients wish to rest in a quiet, dark room.
Mixed tension migraine: This migraine is a headache with features of both tension and migraine headache. The symptoms include headache on one or both sides and the person may feel dull, tight and the pain, which varies from mild to severe, may get worse with activity, lasting from 4 to 72 hours. Sensitivity to light or sound, depression, tingling, sluggishness, numbness, and weakness are other symptoms.
Unfortunately, migraine headache is a recurring chronic ailment, which may recur after 24 hours for some people.
The migraine attack may occur for the first time for boys at about 10 years of age and for girls, the peak age for experiencing a migraine is near 14 years, during their first menstrual period. So, it is sensible to conclude that migraines may be hormonally related and is often referred to as a menstrual migraine.
When compared to other migraines, menstrual migraines last longer, are more severe, occur more often with nausea and vomiting and are more difficult to treat. Migraines are related to changes in the level of estrogen during a woman's menstrual cycle, which drops immediately before the start of menstrual flow.
Premenstrual migraines regularly occur during or after the time when the female hormones estrogen and progesterone decrease to their lowest levels. But generally, migraine attacks disappear during pregnancy. Women who undergo hormone replacement therapy for menopause and those who take birth control pills experience change in the frequency or severity of migraine headaches.
Strictly, a menstrual migraine is the one, which starts from two days before to three days after the first day of period and occurs around most of the periods. There are two types of migraine; pure menstrual migraine is the one, which occurs only around periods and not at other times and menstrual associated migraine is the other that occurs around the periods and at other times too.
Migraines become more frequent while a woman approaches the menopause, since the level of estrogen tends to fluctuate at this stage. However, once past the menopause, the number of migraines tends to reduce. A migraine diary maintained for three months or so helps to see the pattern of migraines and confirm it as a menstrual migraine.
For women, who have a severe menstrual migraine, it is better to prevent them before the attack -at least to make it less frequent and less severe. It is good to maintain a dairy to compare before and after treatment. Once the migraine attack takes place, the treatment for it is the same as for other causes of migraine, such as anti-inflammatory painkillers and taking estrogen supplements.
Anti inflammatory painkillers can be used to treat migraine attacks and a short course can be used to treat as soon as the period starts, until the end of the menstrual period. But people who have duodenal ulcer or asthma cannot take such medications. A few days use of anti-inflammatory pill will have no side effects. Another option for treatment of menstrual migraine is to enhance the level of estrogen just before and during the periods, which is like hormone replacement therapy just for seven days each month.
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