Hormone changes can generate migraines

By Paul G. Donohue M.D.
To Your Good Health
December 09, 2008 6:00 AM

DEAR DR. DONOHUE: My daughter, who is 41, has been getting really bad migraine headaches just before her periods. Is it due to menopause?

— V.M.

Her headaches are not due to menopause. They come from her menstrual cycle, and they’re called menstrual migraines. A migraine sufferer often can identify things that give rise to a headache — foods, alcohol, physical exertion, too little sleep, too much sleep, hunger, bright lights and loud noise. For quite a few women, menstrual periods trigger the headache. The sudden drop in the female hormone estrogen that takes place at the time of a menstrual period precipitates headaches in these women.

Your daughter can take medicine prior to her anticipated menstrual period to prevent the headache. Naprosyn or one of the many other nonsteroidal anti-inflammatory drugs, taken two days before the period begins, often can avert menstrual migraines. They should be taken for as long as the headache has lasted in the past.

Another approach is birth-control pills. The ones that stop periods for six months to a year are particularly useful. Seasonale and Lybrel are two such preparations.

Most migraine sufferers are aware of the triptan drugs, medicines that have had a huge impact on migraine treatment. There are seven such drugs, and I won’t mention them all. Maxalt and Relpax are two of these drugs. The triptans should be used as the anti-inflammatory drugs are used — two days before onset of periods and continued for the length of the usual migraine.

DEAR DR. DONOHUE: I have a plantar wart. What do I do for it?

— C.R.

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