Menstrual migraine

Menstrual migraine has been known as a specific subtype of migraine for centuries. Menstrual migraine is defined as a migraine without aura with attacks occurring around the menstruation in at least two out of three cycles. Beside hormonal factors, inflammatory, genetic and psychosomatic factors probably play a role in the pathophysiology. Menstrual migraine is more difficult to treat than other subtypes of migraine. The acute treatment of attacks is not different from the treatment of other migraine attacks. A specific treatment is short-term prophylaxis in the days before menstruation either with daily naproxen or a daily triptan. Another possibility is a continuous treatment with hormones over the whole menstrual cycle.