05/14/07 #3 - Menstrual Migraines, perimenopause, neck pain?

Health Professional

Full Question:

I have suffered from Menstrual Migraines for about 21 years now. I am in peri-menopause (Dr. confirmed) and the headaches have multiplied 3-fold due to irregular cycles. I also now suffer from more neck pain than ever before, sometimes worse than the pain in my head.

Is there any way to help this neck pain? My husband tries looking for pressure points; I take herbal relaxers and use heat. I DO NOT use any of the triptans anymore as they did not work for me many of the times. I try to avoid aspirin unless absolutely necessary to avoid rebound headaches too. I am desperate for some relief. I lose too many days out of my schedule now and at this time can not even work due to the frequency of these headaches. Also my "aura" seems to have returned recently (floaters in my eyes). I had these when my headaches first started and have gone many years with only a very occasional eye floater. As of late, I have averaged one a week, sometimes followed by a headache (I take 800mg of Motrin as soon as I can) sometimes not. Sometimes headache comes a whole day later.

Help! Any advice? Jean.


Dear Jean;

I feel for your desperation. If I were a woman, I would likely be on the side of the fence in favor of hormonal replacement therapy. Certainly, a free estradiol level can be gotten in the morning and, if on low side of the range, estradiol usually in patch form can be tried in low dosage if there is no contraindication to doing so. Alternatively, a medication called tizanidine can help sleep and reduce frequent non migrainous headaches. We have quite a number of people on this medication; it also helps with sleep. Unfortunately, many physicians are not familiar with it. Consulting a headache expert should also be helpful.

Good luck,
John Claude Krusz and Teri Robert

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