title: Menstrual migraine: an updated review on hormonal causes, prophylaxis and treatment.
abstract: BACKGROUND
  In this article, we will discuss pure menstrual migraine without aura (PMM) and menstrually related migraine without aura (MRM). Depending on the frequency and severity of their attacks, patients with PMM will likely need an acute treatment and/or short-term preventive plan. Of note, with the use of acute treatments and short-term preventive therapy there is risk of medication overuse if the patient does have pure menstrual migraine and is being treated for menstrually related migraine.
  
  
  METHODS
  A PubMed, Cochrane Central, Medline, Ovid search provided articles relating to menstrual migraine pathophysiology and treatment.
  
  
  CONCLUSIONS
  Long-term daily preventive treatment should be considered for patients with MRM and those with severe PMM. Miniprophylaxis can be used in PMM rather than daily preventive treatment. When considering the use of short-term miniprophylaxis, sumatriptan, zolmitriptan, naratriptan, and frovatriptan have shown efficacy; however, frovatriptan appears to be the triptan of choice based on overall efficacy. Oral contraceptives may be considered if patients do not respond to or cannot tolerate typical migraine preventive medications. In patients with migraine with aura, oral contraceptives should be used with caution as this may add to the risk of stroke in this population.
authors.affiliation: Jefferson Headache Center , 900 Walnut St, Suite 200, Philadelphia PA 19107 , USA +1 215 955 2243 ; stephen.silberstein@jefferson.edu.
authors.forename: Stephen
authors.initials: S
authors.lastname: Silberstein
authors.forename: Sumit
authors.initials: S
authors.lastname: Patel
mesh_terms: D002986:Clinical Trials as Topic; D003276:Contraceptives, Oral / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008598:Menstruation; D020326:Migraine without Aura / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014363:Tryptamines / Q000627:therapeutic use
chemical_list: D003276:Contraceptives, Oral; D014363:Tryptamines
keywords: estrogen; menstrual; migraine; treatment