Best preventative treatment for a 45 yr old female with predictable severe, perimenstrual migraine.

thank you for your post! I just started getting migraines with my cycles about 3 years ago and it is has grown into almost daily migraines. I am 34 and very concerned that estrogen is playing a part in this. I have heard both sides of the birth control issue in treating these kinds of headaches. So, I really appreciate your post; it means that it may be an option worth exploring. Thank you!

Hi, glad my comments were helpful.  Daily migraines - wow, that has got to be rough.  And as you said, you've heard both sides, and my doctor recently advised against taking birth control pills at all since I sometimes get visual aura, but she left the decision up to me, which I appreciated because I know my body and I know what I can live with.  But yes, it's definitely worth trying something different if you're suffering daily migraines as it is.  Best wishes to you.

Karen

HI Kat,

What are your auras like? I get floating or flashing lights ocassionally when I have my migraine so they diagnosed me with auras. However, I've heard from many people that they get auras right before their migraine and it is very definite.

Hi Kelly,

I get the flashing, silvery zig zag pattern that resembles a backwards letter C, and as it fades it grows wider and more faint, until after 5 or 10 minutes it's gone.  How long do your auras last?  What's odd is that my auras usually occur independently of the headache, and have different triggers.  Bright sunlight will trigger an aura like that for me, but my migraine pain is usually hormonal.  I asked my eye doctor about the auras once, and was surprised when she told me she gets them too, and asked me if I ever get auras and not get the headache wth them, which she said is not uncommon.  So it sounds like you're like me and the auras occur less frequently than the migraine headaches.  And for me the auras have just been passing annoyances and I haven't worried much about them once I understood what they were, but the minute you tell your MD you get auras it's like a red flag and then they advise you against taking birth control pills because there's a slightly higher risk of stroke.  I did a lot of internet research and learned that some birth control pills are worse than others for stroke risk, and I read some pretty scary things about the Nuvaring which I did try once for awhile, so unfortunately it's a tough decision and you need to evaluate your overall health status and other risk factors for stroke, and work with your doctor to determine your best options for birth control.  There was a thread I recently viewed on MyMigraine.com with a link for more info about auras.  I looked at it briefly, but I don't think there's much else you can do about the visual auras, except don't drive when you're having one!  ;)  When I'm having one and when I try looking straight ahead, I really can't see well out of the affected eye - and usually it's just one eye.  Unfortunately it seems like migraines and auras (and especially the migraine-hormone connection) are not well understood by the medical community, so we struggle along...

Please let me know how things go for you.

Karen

Hi Karen,

Thank you for your nice response. I went to a new OB/GYN last week and she is actually having me go to a reproductive endo. to review my hormones. She advised me to start taking Loestrin24, which is apparently the lowest dose of estrogen. She was amazed that no one has checked my estrogen since my lh and fsh levels are off. I'm so hopeful that this may help. I'm kind of at the end of my rope. I am seeing a Headache Specialist at Mayo Clinic and we are trying different meds. apparently they have diff. protocols they have to try before putting you in the hospital. I'm 34, fit and trying to have a good life. My boyfriend of 9 years left last year; so I am feeling very alone in this fight right now. I am trying to be hopeful, but everything I read about chronic daily migraines is kind of depressing. I appreciate your information about how hormones/birth control have helped you. It is interesting to read about your auras, mine aren't like that...so I'm never really sure if I have a migraine coming on. That is one good thing, I guess, you know when it is coming, right? ~ Kelly

Hi Kelly,

Thanks for sharing.  It sounds like your new OB/GYB knows what she's doing and I'll be interested to know the outcome when you see the reproductive endo.  I'm sorry to hear that your relationship broke up at a time when you most need someone to be supportive.  How long have you been seeing the heachache specialist at Mayo?  You'd think they'd have all the answers, wouldn't you?!  Did triptans help at all?  Even if so, they're too expensive to take on a daily basis.  Are you also bothered by light and/or sound?  Today I met a friend for lunch and they seated us right under a speaker that was blaring the most annoying music.  I immediately asked to be moved and they said "oh we can turn it down".  My friend looked at me like I was being irrational for making a fuss, but I really can't tolerate loud noise or bright light.  And that has gotten worse as I get older.  My migraines though, have not gotten worse with age - at least not since they seemed to reach their peak when I was about your age.  So, again, you can't tell me they're not strongly related to hormones when there are so many common factors among reproductive-aged women. 

Take care and please do let me know your progress.

Karen

Hi Karen,

Thank you for your post. I have been seeing this specialist for the past 3 months and unfortunately headaches have only gotten worse not better. Supposedly they try different protocols until they hospitalize you? something like that. I meet with the rep. endo on wednesday and will let you know what i find out. I'm very scared right now that this may not get better. I'm more concerned about being on high doses of medication that will affect me so much I will not be able to function like a normal person and/or have a life. I'm glad you have found something that has worked for you. you still have your short monthly migraines? And yes, lights and loud music like that are a recipe for disaster :) Which is a bummer, I loved going to concerts!! I have found that earplugs are helpful on some days at work :). ~Erin