In perimenopause phase of life, at wit's end with 4 - 6 Migraines a week?

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    I am 51 years old, have had migraines for 12 - 13 years, and in the past month or two, have gone from 1 - 3 migraines a week, to 4 - 6 a week. I am in the perimenopause stage of my life. My neurologist has had me try almost every kind of preventative medication there is, and nothing has helped, at least not for long. I take Imitrex or Maxalt for relief, but try not to overuse these for fear of rebound headaches. I am about at my wit's end. I would like to find a headache specialist, but the closest one I can find online is 3+ hours away from me. I have tried gluten free diets, chiropractic, kiniesiology, etc, etc. I don't know where to go from here. I am tired of having headaches almost every day of my life, making it hard to go to work, or enjoy everyday life. Any suggestions?

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    Thanks, Melody.


    Full Answer:

    Dear Melody;


    Do you know what triggers your Migraines? Trigger identification and management is a vital component of managing Migraine disease. One of the best tools for identifying triggers is a good Migraine diary. You can download a free diary workbook from our article Your Migraine and Headache Diary. Some of us have food triggers; some of us don't. It's advisable to determine if your daughter does, and an elimination diet is the best way to do that. For more information and a workbook on this, see Managing Migraine - Migraine Trigger Foods. It's possible that hormonal fluctuations associated with perimenopause are triggering some of your Migraines or making you more susceptible to other triggers.


    How long did you try these preventive medications. If you tried each of them for less than three months, you didn't really try them long enough to be effective. It's also important to realize that if you try one medication of a particular kind - say, a beta blocker such as propranolol - and it doesn't work for you, that doesn't mean that none of the drugs of that type will work. We have over 100 medications and supplements in use for Migraine prevention these days, so giving each of them a fair trial of three months would take about 25 years. You can fine more information, including a listing of these medications in Migraine preventive medications: too many options to give up!


    When it comes to seeing a specialist, each patient needs to (unfortunately) decide how important it is to them. There simply aren't enough qualified specialists, so there are none at all in some states and areas. Three hours is nothing to sneeze at, but it's a shorter distance than many Migraineurs travel for expert treatment. You didn't mention where online you looked for a specialist, but if you haven't seen our listing of patient recommended specialists, you can find a link to it below.


    Good luck,
    John Claude Krusz and Teri Robert



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    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    Last updated February 21, 2011.

Published On: February 21, 2011