Menstrual migraine and adolescence
The association between menstruation and migraine headaches may start to become evident during adolescence.
The association between menstruation and
migraine headaches may start to become evident during adolescence.
Headache and migraine are commonly seen in adolescent girls but menstrual migraine is well-recognised only in adult women. The migraine attacks during menstruation are different from other migraine attacks within individuals as they tend to be more severe and are more likely to occur prior to
menstruation. Researchers from America studied 896 girls between the age 9 and 18 years old to characterise menstrually-associated headaches and migraine in adolescent girls and identify any developmental and pubertal changes.
It was found that of 896 girls, 50 percent of menarchal girls (those who had just started to menstruate) and 37 percent of all girls reported experiencing headaches with their menstrual period. Overall, 77 subjects (64 percent) who reported a menstrual pattern noted that migraines started between day -2 and day +3 of their menstrual period start. There were more associated symptoms (unilateral headaches, pulsating pain, constant pain,
nausea, photophobia) among girls with menstrual migraine compared to those without it. Girls with menstrually-related migraine were, however, no more disabled than girls without menstrually-related pattern, which is in contrast to that seen in adults where women with menstrual migraine are more disabled. The researchers also noted that the incidence of migraine increased as girls grew older but the percent of girls who experience it remains constant after onset. A monthly pattern of headache was also reported by 160 girls who had not yet begun to menstruate or had only just started their periods.
The researchers concluded that menstrual migraine either develops with onset of puberty or does not develop at all and that females with menstrually associated migraine have a different biological or genetic basis to their migraine headaches.
This is explained by the fact that menstrually-related migraine is a hormonal event sensitive to the fluctuations in ovarian hormonal levels as evidenced by an increased prevalence of migraine during times of ovarian hormone activity (puberty) and its decline with menopause. The ovarian hormones progesterone and estrogen modulate migraine as they affect the neurotransmitter systems and pain processing networks responsible for migraine.
Studies need to be conducted to investigate effective treatment strategies for menstrual migraine in adolescents because of its predictable nature.
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