The predominance of the female sex in migraine (3: 1) and tension headache (5: 4) is well known. In tension-type headaches, the prevalence of women is more likely due to various gender-based psychological and psychosocial factors as well as behavioral differences. In the case of migraine, however, many observations support the hypothesis of hormonal influence on the onset of pain. This is often to the association of migraine with the menstrual cycle, the frequent improvement during pregnancy, the deterioration by taking hormonal contraceptives and the improvement and rare deterioration during menopause.
The term “menstrual migraine” should be reserved for migraine attacks that occur only during the first three days of the menstrual period and 2 days before. The attacks of true menstrual migraine usually characterized by high pain intensity, long duration and intense side effects such as nausea and vomiting.
Mostly it is a migraine without aura, i. without transient neurological symptoms such as visual disturbances, abnormal sensations, speech disorders and, less commonly, paralysis. Other features of the menstrual migraines affect their difficult treatment compared to usual migraines, frequent non-response to medication and the strong tendency to recur after temporary improvement.
What is important is a correct diagnosis, which must be recorded by means of a corresponding calendar.
The cause is a number of mechanisms that are not fully understood. Worth mentioning is the sudden drop of a high over several days Oestrogenspiegels Also, the settling of the pill after 21 days can trigger such a so-called hormone withdrawal headache.
Premenstrual syndrome (PMS)
Despite similar symptoms, one should try to distinguish menstrual migraine from headache as part of premenstrual syndrome. This refers to the coincidence of headache with various other symptoms that occur a few days before and during the menstrual period. This is about physical symptoms such as breast tenderness, fluid retention in the legs or appetite disturbances, and mental symptoms such as irritability, anxiety, depression and mood swings and breakouts.