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How To Treat Migraine Symptoms



I Get Migraines Right Before My Period Could They Be Related To My Menstrual Cycle

More than half of migraines in women occur right before, during, or after a woman has her period. This often is called “menstrual migraine.” But, just a small fraction of women who have migraine around their period only have migraine at this time. Most have migraine headaches at other times of the month as well.

How the menstrual cycle and migraine are linked is still unclear. We know that just before the cycle begins, levels of the female hormones, estrogen and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals in the brain that affect a woman’s pain sensation.

Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.

What Are The Possible Side Effects Of Medicines Given In The Er To Treat Migraines

Researchers found that the side effects from these medicines are usually minor and temporary. Some of the medicines can cause drowsiness, so you may not be able to drive right away. More information is listed below for each type of medicine when it is taken a single time in the ER for a severe migraine.

  • Neuroleptics/Antiemetics: Restlessness in the legs or body is a common side effect. A possible serious side effect is uncontrollable muscle movements, such as tics and tremors.
  • Sumatriptan: The most common side effect is pain or swelling at the place where the shot was given. Other side effects can include redness in the face and neck, a burning feeling, feelings of tightness , and drowsiness.
  • NSAIDs: Side effects are not common with these medicines.
  • Opioids: Tiredness and drowsiness are common side effects.
  • Dihydroergotamine: The most common side effects include pain or swelling at the place where the shot was given or where the IV needle was put in, drowsiness, stomach problems, nausea and vomiting, and an irregular heartbeat.
  • Dexamethasone: Side effects were not common with this medicine in the research studies. But, possible side effects can include nausea, headache, dizziness, and trouble sleeping.

Note: There are other possible side effects of these medicines. The side effects listed here are the most common side effects when the medicines are taken a single time in the ER for a severe migraine.

Q When Do Migraines Begin In A Persons Life Is There A Particular Time

A. There is no particular time when migraines can develop in a person’s life. Most people have noticed that migraines have started developing when they were teenagers. In the 30s, migraines tend to be at their most severe. In your 40s, migraines tend to become less severe and more bearable as you age. However, a migraine can occur anytime and it varies from person to person. Usually stressful times and menstruation are times people suffer from migraine attacks. There are so many factors involved that it becomes difficult to predict.

How Does Migraine Differ From A Cluster Headache Or Tension Headache

A migraine differs from a cluster headache in several ways. A main difference is their duration. Cluster headaches usually last for 30 to 90 minutes, can happen many times in one day , and then not return for many weeks or months. Migraine headaches are longer, often a full day or several days if not treated, and can return often during the same month. Cluster pain is centered around the eye, and is sharp. With clusters, there often is tearing of the eye, redness in the white area of the eye, or stuffiness of the nose .

The onset of both migraine and tension headaches often is “triggered” by something in one’s environment, such as stress, lack of sleep, or change in hormones. Cluster headaches are caused by changes in the brain not in the environment, and therefore onset is not “triggered” by something around you. Clusters often run in “clusters or cycles” of time, for a number of weeks or months. They often occur about the same time of year.

What Are The Types Of Headaches What Type Of Headache Is A Migraine

Migraine Symptoms: The stages of a migraine

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.

What Are The Four Stages Or Phases Of A Migraine Whats The Timeline

The four stages in chronological order are the prodrome , aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.

The phases are:

  • Prodrome: The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the “preheadache” or “premonitory” phase.
  • Aura: The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time.
  • Headache: About four hours to 72 hours is how long the headache lasts. The word “ache” doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.
  • Postdrome: The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” and 80% of those who have migraines experience it.
  • It can take about eight to 72 hours to go through the four stages.

    When Should I Seek Immediate Help Or Contact My Healthcare Provider

    • You are experiencing the “worst headache of my life.”
    • You are having neurologic symptoms that you’ve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
    • Your headache comes on suddenly.
    • You have a headache after experiencing a head injury.

    Schedule a visit with your healthcare provider if:

    • The number or severity of your headaches increase or your headache pattern changes.
    • Your medications no longer seem to be working or you’re experiencing new or different side effects.

    If My Headache Isn’t Going Away Should I Get Tested For Coronavirus

    Headache is one of the symptoms of COVID-19, the illness caused by the novel coronavirus SARS-CoV-2, according to the Centers for Disease Control and Prevention . A February 2020 report of the WHO-China Joint Mission on COVID-19, from early in the pandemic, found that of 55,924 people confirmed to have the disease, 13.6 percent had a headache.

    There’s no treatment for COVID-19, but the same OTC pain relievers that help with other types of headaches may alleviate headaches caused by this disease. does not recommend against the use of ibuprofen for people with COVID-19.)

    If you have symptoms of COVID-19 and want to get tested, the CDC recommends calling your state or local health department or a medical provider. Most people with COVID-19 have mild illness and are able to recover at home, the CDC notes.

    RELATED:A Guide to Living With Migraine During the COVID-19 Pandemic

    What Natural Home Remedies And Lifestyle Changes Relieve Migraines

      Migraine patients can play a significant role in managing their headache frequency and severity.

      Keep track of when migraines occur by using a headache diary or log to track pain levels, triggers, and symptoms. In addition, patients should keep track of the migraine types they experience . This can help identify patterns that precede a migraine, as well as help identify factors that contribute to the development of the headache. Once these contributing factors are known, lifestyle modifications can lessen their impact. These modifications may include:

      • Maintain a regular schedule for eating and sleeping.
      • Avoid certain foods that might cause a migraine.
      • Keep well hydrated since dehydration has been identified as a migraine trigger for some people.
      • Exercise regularly.
    • Relaxation strategies and meditation also have been recognized as effective strategies to prevent migraines and decrease their severity.
    • Exercise and migraine

      Some people find that exercises that promote muscle relaxation can help manage the pain of migraines. Examples of types of mind-body exercises that can help encourage relaxation are:

      • Meditation

      So What Are The Types Of Migraine And Chronic Headache Disorders

      When seeking a diagnosis, your doctor will first try to determine if the type of headache you are experiencing is itself a disease or a symptom of another disease .

      A primary headache is caused by overactivity of – or structural issues with – the brain’s processing and sensitivity centers. Various structures may play a role including your brain’s chemical activity, the nerves or blood vessels around your skull, your head and neck muscles, or a combination of all of these. Genetics can also play a role.3

      Common primary headaches include:4

      • Tension/stress headache: occurs in 75% of the US population. Also known as muscle contraction headache, psychomyogenic headache, ordinary headache, essential headache, idiopathic headache, and psychogenic headache
      • Migraine with aura: occurs in 25% of people who experience migraine
      • Traditional migraine: occurs in 12% of US population
      • Cluster headache: occurs in 0.1% of the US population.

      If you are told you have a secondary headache, that means there is an underlying condition that may be causing your headaches. Several conditions may be responsible for secondary headaches as described below.

      Read more about what each headache type feels like below.

       

      Which Migraine Medications Are Safe To Use While Breastfeeding

      Although it is safest to avoid all medications if breastfeeding, this is not always feasible. Therefore, to avoid unwanted side effects in the breastfeeding infant, medications should be used at the lowest effective dose and for the shortest duration. Generally, the same medications used during pregnancy can be continued after delivery and while breastfeeding. An exception is aspirin which may cause bleeding problems and Reye’s syndrome in the nursing baby and should therefore be avoided. Mothers who must take medications should also consider not breastfeeding.

      Divalproex should not be used in patients with liver or pancreatic disease.

      What Symptoms Must You Have To Be Diagnosed With A Migraine

      Migraine with aura . This is a headache, plus:

      • Visual symptoms or vision loss.
      • Sensory symptoms .

      Migraine without aura . A common migraine is a headache and:

      • The attacks included pain on one side of your head.
      • You’ve had at least five attacks, each lasting between four and 72 hours.

      Plus, you’ve experienced at least one of the following:

      • Nausea and/or vomiting.
      • Lights bother you and/or you avoid light.
      • Sounds bother you and/or you avoid sounds.

      What Else To Expect When Living With Headaches And Migraine

      New Treatment Provides New Hope For Migraine Sufferers

      If you are diagnosed with migraine, you may experience symptoms BEFORE and AFTER the attack. But there are warning signs that can clue you in when a bad headache is on the way.

      According to the American Migraine Foundation, this time before the onset of a headache is referred to as the prodrome period, “preheadache” or “premonitory” phase.8 Not everyone who experiences migraine will have these warning signs, but knowing what these signs are if you do experience them is important so you can seek out treatments to help prevent the attack. These early warning signs can occur between several hours to up to several days before an attack and include:

      • subtle changes to your day-to-day life, including constipation, mood swings, food cravings, neck stiffness, increased thirst and urination, and frequent yawning
      • difficulties concentrating

      In addition, some people with migraine may be more likely to have chronic dry eye disease.9

       

      Which Migraine Medications Are Safe To Use During Pregnancy

      Migraine headaches may become less frequent during pregnancy. However, in rare cases migraines may appear for the first time during pregnancy or become worse. Non-drug therapies are considered to be safer during pregnancy, they should be tried first. Non-drug therapies such as relaxation, sleep, massage, ice packs, and lifestyle changes are considered first-line options during pregnancy.

      If drug treatment is required, acetaminophen is usually the treatment of choice. When used appropriately, acetaminophen treatment does not affect the pregnancy or the unborn baby.

      Nonsteroidal anti-inflammatory drugs are considered second-line options and thought to be safest in the second trimester. They should not be used near the time of birth. Opioids are third-line options. Prolonged use of opioids may cause addiction and dependence in mothers and child.

      Triptans are reserved for moderate-to-severe symptoms in women who have failed to adequately respond to other treatments. Sumatriptan is the oldest and most studied triptan in pregnancy. A pregnancy registry for sumatriptan did not find an increased risk of birth defects or miscarriage in 600 patients who were treated with sumatriptan during pregnancy.

      Ergotamines should not be used during pregnancy as they may potentially induce hypertonic uterine contractions and vasospasms/vasoconstrictions which can cause harm to the unborn baby.

      Q What Is The Difference Between A Headache And A Migraine

      A. Migraine headache versus headaches might seem like a similar condition but their medical diagnosis and treatment is completely different. Headaches do have their own severity depending on how long they last or what type of headache it is. Headaches cause pain in the head, face, sides of the head, or upper neck. It often varies in frequency and intensity. Whereas migraine is an extremely painful primary headache disorder, often accompanied by nausea or light sensitivity. Before a migraine begins, the patient might feel some aura like they can see flashes of light or experience tingling sensations in the limbs.

      Why Your Mental Health Matters With Migraine And Headaches

      Missed days at work. So fatigued you’re in bed all day. Blinded by the dimmest of lights. Is it any wonder that those battling chronic headaches also experience a blow to their mental health?

      About 20% of people who experience migraine on 14 days or fewer each month may have depression and/or anxiety, according to the American Migraine Foundation. For people who experience migraine more days a month , depression and/or anxiety is even higher – between 30% and 50% for anxiety.12 The same inherited brain chemistry that causes migraine may also be involved in anxiety and depression. Depression increases headaches, and headaches increase depression, so they both must be treated.

      For some, depression and anxiety may appear months or years after living with the often-debilitating pain of migraine and headaches. It is not uncommon for migraineurs to say they spend several days a month in bed because of their migraine or headache attacks. For others, depression and anxiety, just like migraine, may run in the family.12

      If you find yourself lying in bed day after day, even after your migraine or headache passes, you may be experiencing a residual mental health issue. Talk to your doctor or headache clinic about a referral to a psychologist for talk therapy and home-based strategies.

      PPM recently held a video chat House Call on migraine and mental health. Check it out to get some common questions answered as well as a few self-help tips.

      How Can I Tell If I Have A Migraine Or Just A Bad Tension

      Compared with migraine, tension-type headache is generally less severe and rarely disabling. Compare your symptoms with those in this chart to see what type of headache you might be having.

      Migraine vs. bad tension-type headache

      Symptom
      Aura before onset of headache x

      Note: Rebound headache may have features of tension and/or migraine headache. Adapted from a table produced by the American Council for Headache Education.

      Although fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by certain foods, changes in the body’s hormone levels, and even changes in the weather.

      There also are differences in how types of headaches respond to treatment with medicines. Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.

      You can’t tell the difference between a migraine and a tension-type headache by how often they occur. Both can occur at irregular intervals. Also, in rare cases, both can occur daily or almost daily.

      Q Are There Any Preventative Medications That I Can Take

      A. There are several preventative medications that you can take so that you don’t have to go through migraine pain. These types of medications are usually prescribed to those people who have migraine attacks that last a long time. Examples of preventative medications include antidepressants, Fremanezumab, medications that lower your blood pressure, and anti-seizure drugs.

      Can A Migraine Cause A Stroke What Are The Risk Factors

      Migraine and stroke may occur at the same time, but a causal link has not been established. When an ischemic stroke occurs during a migraine attack it is called a “migrainous infarction.” The specific type of migraine associated with an increased risk of ischemic stroke is migraine with aura, a type of migraine that affects about one-quarter of all people with migraines. Rarely, people with specific migraine symptoms may be related to a higher risk of stroke.

      Migraines may be a risk factor for stroke, in that strokes occur more frequently in people who have had migraines, but the strokes do not necessarily occur during migraine attacks.

      What Are The Symptoms Of Migraine In Children And Teens

      For children and teens, sensitivity to light and sound are two telltale symptoms of impending migraine.

      Migraine headaches also tend to be bilateral at this age. This means that the pain is present on both sides of the head.

      Generally, migraine attacks are also shorter for people in this age group. The average length for adolescents lasts about 2 hours.

      Adolescents may experience chronic daily migraine, which is one of the most disabling types. This means that they experience “headache days” per month. Each headache day is characterized by a migraine headache that lasts more than 4 hours.

      This recurrence must happen for more than 3 months for the condition to be considered chronic.

      • caffeine withdrawal or too much caffeine
      • foods that contain nitrates, such as hot dogs and lunch meats
      • foods that contain monosodium glutamate, which is a flavor enhancer found in some fast foods, broths, seasonings, spices, Chinese food, and ramen noodles
      • foods that contain tyramine, such as aged cheeses, soy products, fava beans, and hard sausages
      • sulfites, which are chemicals that are commonly used as preservatives
      • aspartame, which is found in sweeteners such as NutraSweet and Equal

      Other foods sometimes considered to trigger migraine attacks include:

      • chocolate
      • tannins and phenols in black tea
      • bananas
      • apple skins

      Ask your teen to record the frequency and intensity of their migraine symptoms in a journal.

      Because of this, your family history may be able to help guide your doctor to a diagnosis.

      Prescription Painkillers For Frequent Tension Headaches

      Medical Addicts: Migraine Symptoms, Signs and Treatment

      For those people who have frequent or recurring tension headaches, doctors sometimes recommend prescription-strength doses of nonsteroidal anti-inflammatory drugs , such as ibuprofen or naproxen.

      Indocin , an NSAID that is available only by prescription, is “usually used for arthritis, but can also be very useful as a headache treatment,” Dr. Rozental says. “Indomethacin‘s downside is that it is among the drugs most likely to cause gastric irritation as a side effect,” including stomach ulcers and bleeding. It can also harm kidney function if taken at high doses or chronically.

      How Can I Tell If I Have A Migraine Or A Sinus Headache

      Many people confuse a sinus headache with a migraine because pain and pressure in the sinuses, nasal congestion, and watery eyes often occur with migraine. To find out if your headache is sinus or migraine, ask yourself these questions:

      In addition to my sinus symptoms, do I have:

    • Moderate-to-severe headache
    • Nausea
    • Sensitivity to light
    • If you answer “yes” to two or three of these questions, then most likely you have migraine with sinus symptoms. A true sinus headache is rare and usually occurs due to sinus infection. In a sinus infection, you would also likely have a fever and thick nasal secretions that are yellow, green, or blood-tinged. A sinus headache should go away with treatment of the sinus infection.

      The Empowered Patient’s Guide To Migraine And Headache

      Knowing what type of headache you are experiencing–whether from stress, cluster attacks, or inherited migraine–is the first step in finding relief. Here’s a look at the symptoms, triggers, and treatments.

      Lawrence Robbins, MD

      Migraine headaches are like the bully who won’t leave you alone. But here’s the thing you should know—regardless of your headache trigger—you are in control so it’s important to seek treatment. Many people don’t and suffer needlessly.

      All headaches are bullies. But while some are short-lived hindrances , others are relentless and soul-crushing in their taunts .

      In fact, if we put together a lineup of these bullies, it would be half-a-dozen-headaches long. Here’s the thing, though: No matter what kind you get, you are in control. Many people don’t realize this and never seek diagnosis or treatment. In fact, many headache attacks can be prevented with a few simple changes. But since you’re here, we realize you’re not one of those people, so let’s get you some relief.  

       

      Can Using Birth Control Pills Make My Migraines Worse

      In some women,  pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe. But in other women, the pills may worsen their migraines. In still other women, taking birth control pills has no effect on their migraines.

      The reason for these different responses is not well understood.  For women whose migraines get worse when they take birth control pills, their attacks seem to occur during the last week of the cycle. This is because the last seven pills in most monthly pill packs don’t have hormones; they are there to keep you in the habit of taking your birth control daily. Without the hormones, your body’s estrogen levels drop sharply. This may trigger migraine in some women.

      Talk with your doctor if you think birth control pills are making your migraines worse. Switching to a pill pack in which all the pills for the entire month contain hormones and using that for three months in a row can improve headaches. Lifestyle changes, such as getting on a regular sleep pattern and eating healthy foods, can help too.

      Are Migraine Headaches More Common In Women Than Men

      Yes. About three out of four people who have migraines are women. Migraines are most common in women between the ages of 20 and 45. At this time of life women often have more job, family, and social duties. Women tend to report more painful and longer lasting headaches and more symptoms, such as nausea and vomiting. All these factors make it hard for a woman to fulfill her roles at work and at home when migraine strikes.

      What Are The Different Types Of Migraine Medications

      Migraine medications fall into two major categories.

      • The first contains drugs that abort or stop migraines from progressing once they begin. The earlier these drugs are used in a migraine attack, the better they work.
      • The second category contains drugs that prevent migraines from happening.

      Over-the-counter migraine medications used to address pain include analgesics, NSAIDS, and caffeine, including:

      • Naproxen
      • Ibuprofen
      • Acetaminophen
      • Or combinations of these

      One drawback to using analgesics and NSAIDs is that taking them daily can make headaches worse due to medication overuse.

      Prescription drugs used to provide relief from pain include

      • NSAIDs and

      Like over-the-counter medications, prescription drugs often come in combinations.

      • A barbiturate called butalbital is often used in combination with acetaminophen, and
      • caffeine with or without codeine .

      Barbiturates are a sedative and may be useful to help people sleep off the pain.

      While analgesics, NSAIDs, and narcotics relieve pain, they don’t address the underlying physiology — primarily the dilation of blood vessels in the brain. Two classes of migraine drugs are:

      • ergotamines and 
      • triptans.

      Ergot alkaloids — such as ergotamine tartrate and dihydroergotamine mesylate — are potent drugs that constrict blood vessels. Because nausea is a possible side effect of these migraine drugs, some people take ergotamines in combination with other drugs to prevent nausea.


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