Management of Menstrual Migraine

BACKGROUND: Migraine is more prevalent in women than men. Hormonal changes can influence the occurrence of migraine, particularly related to the menstrual cycle. Menstrual migraine may require both acute and preventive treatment. REVIEW SUMMARY: Gender differences in migraine may be a result of variations in the central nervous system of men and women as well as the effects of estrogen. Migraine attacks occurring in the perimenstrual period respond well to acute treatment with triptans. Hormonal manipulation may reduce migraine occurrence, especially when related to hormonal fluctuations in the perimenstrual period. CONCLUSIONS: Effective migraine management requires an understanding of the unique epidemiologic and pathophysiological factors affecting women. An understanding of associated hormonal influences facilitates development of individualized treatment plans.