The term ‘Premenstrual Syndrome’ (PMS) refers to the mood changes and physical symptoms which occur cyclically in the second half of the menstrual cycle, and might interfere with a woman’s ability to perform day-to-day activities. The following write-up provides information on menstrual headaches, which occur before or during periods and affect women in the age group of 20 to 55 years.
Headaches are medically referred to as cephalalgia. The term ‘menstrual cephalalgia’ refers to headaches that usually occur before, during, or after the menstrual cycle, or at the time of ovulation. Research suggests that about 60% of women experience these aches during their menses, out of which nearly 10% experience severe pain or migraines.
Menstrual associated migraine (MAM) are of two types: premenstrual and menstrual. While the former occur between one to seven days, that is, a week before the period start, the latter can start from the day before the period begins, and continue up to four days.
In the menstrual cycle, at different stages, hormones such as (estrogen and progesterone) are produced by the ovaries. The interactions of these hormones with the neurotransmitters (chemicals that serve as messengers) in the brain, results in MAM/PMS. These aches are usually caused due to changes in the estrogen levels in the body. Prior to menstruation, estrogen and progesterone levels fall instantly, especially for women in the age group of late thirties and forties. This sudden decline acts as a trigger for these pains.
In fact, research shows these headaches are more severe in women taking birth control pills containing high doses of estrogen. While these aches are less common in women taking oral contraceptives having lower doses of estrogen or containing progesterone. Some other causes include malfunction of platelets, or low levels of magnesium and endorphins.
The symptoms are similar to migraine. It begins as a one-sided pain and gradually increases in severity, accompanied by the following symptoms:
- Double vision
- Dizziness and weakness
- Mood swings
- Sensitivity to bright lights and sounds
- Ringing in ears or hearing loss
- Loss of balance
Medications prescribed to treat these aches are non steroidal anti-inflammatory medications (NSAIDs) including Orudis, Advil, and Motrin; Nalfon, Naprosyn, and Relafen. These medications can be started two to three days before the menstruation starts and continued until the period ends. Women who wish to continue with the birth control pills, but have severe headaches are recommended to start taking these medications from the 19th day of the cycle and continue till the second day of the next cycle.
Small doses of ergotamine drugs including Bellergal-S, Bafergot, Migranal; beta-blocker drugs like Propranolol; anticonvulsants like Valproate (Depakote); and calcium channel blockers such as Verapamil, can also be taken two to three days prior to the menses, and continued throughout the cycle. However, it’s best to consult a gynecologist before starting these medications.
Pregnant women should refrain from the use of the aforementioned medications, as these can affect the uterus and hamper the baby’s growth. In severe cases wherein drug therapy doesn’t prove beneficial, hormonal therapy is advised. In this therapy, supplemental estrogen can be administered to the patient before the period, either by mouth or through a transdermal patch. Estradiol (0.5 mg tablet twice a day, or 1 mg patch) is one of the recommended form of estrogen that is given to the affected.
Incorporating foods that encourage estrogen production in the body like soy, apples, alfalfa, cherries, potatoes, rice, wheat, and yams in your diet; limiting caffeine; eating regularly to maintain blood sugar levels; practicing yoga, meditation, and some breathing exercises are considered to be effective natural remedies. However, if the aches do not subside even after trying the aforementioned remedies, an expert needs to be consulted at the earliest.
Disclaimer: This HerHaleness article is for informative purposes only, and should not be used as a replacement for expert medical advice.