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What Should I Do For Migraine Headache

Q What Is The Link Between Migraine And Hormones

Is it normal to get migraine headaches during pregnancy, and what should I do about them?

A. Hormones start and direct a large number of your body’s capacities, keeping your body in balance inside a continually evolving condition. At the point when the count of hormones in your body are uneven during period, pregnancy, or menopause it may prompt a headache. Actually, around seventy five percent of all women with headache report that pain is identified because of the feminine cycle.

Who Gets Migraines What Are The Risk Factors

Its difficult to predict who may get a migraine and who may not, but there are risk factors that may make you more vulnerable. These risk factors include:

  • Genetics: Up to 80% of people who get migraine headaches have a first-degree relative with the disease.
  • Gender. Migraine headaches happen to women more than men, especially women between the ages of 15 and 55. Its likely more common in women because of the influence of hormones.
  • Stress level. You may get migraines more often if youre high-stress. Stress can trigger a migraine.
  • Smoking.

What Are The Symptoms Of A Migraine

Individual migraines are moderate to severe in intensity, often characterized by a throbbing or pounding feeling. Although they are frequently one-sided, they may occur anywhere on the head, neck and face or all over. At their worst, they are typically associated with sensitivity to light, noise and/or smells. Nausea is one of the most common symptoms and it worsens with activity, which often results in patient disability. In many respects, migraines are much like alcohol-related hangovers.

Migraine pain can be felt in the face, where it may be mistaken for sinus headache or in the neck, where it may be mistaken for arthritis or muscle spasm. Complicating the diagnosis of migraine is that the headaches may be accompanied by other “sinus like” symptoms, including watering eyes, nasal congestion and a sense of facial pressure. Most patients who think they have sinus headache in fact have migraines.

In up to 25 percent of patients, the migraine headache pain may be preceded by an aura, a temporary neurological syndrome that slowly progresses and then typically resolves just as the pain begins. While the most common type of migraine aura involves visual disturbances , many people experience numbness, confusion, trouble speaking, vertigo and other strokelike neurological symptoms. Some patients may experience auras without headaches.

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What Is Hypnic Headache

Hypnic headache more often occurs in people above the age of 50, occurs exclusively during sleep such that it wakes the person up, and can last between 15 minutes and 4 hours if untreated.

Liang JF, Wang SJ. Hypnic Headache: A Review of Clinical Features, Therapeutic Options and Outcomes. Cephalalgia. September 2014.

What Type Of Doctor Do You See For Ocular Migraines

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If you have ocular migraines, you can see an ophthalmologist oran optometrist.

Optometrists are eye care specialists who offer primary vision care services, including:

  • Vision testing
  • Correction of visual problems
  • Treatment and management of visual issues and eye diseases

On the other hand, ophthalmologists are medical practitioners who specialize in eye and vision care. They differ from optometrists in their degrees of schooling as well as what they can diagnose and cure.

An ophthalmologist is a healthcare professional who has finished college and has at least eight years of further medical studies. He or she is licensed to practice medicine and surgery. Ophthalmologists hold a Doctor of Medicine degree.

Optometrists are healthcare professionals who complete four additional years of school after finishing undergraduate studies. They hold a Doctor of Optometry degree.

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What Can I Do To Help Relieve The Symptoms Of A Menstrual Migraine

Do your best to figure out what makes your hormone headaches better or worse. For example, if light causes pain and you feel overheated, stay in a cool, dark room. Additional tips include:

  • Keep your blood sugar levels up by eating small, frequent snacks. Never miss a meal.
  • Learn relaxation techniques.
  • Avoid too little or too much sleep, and keep a regular sleep pattern.
  • Change your diet, if needed.
  • Avoid stress when you can, and learn how to manage it when you cant.

Make A Treatment Plan

Developing a good relationship with the doctor who is helping you manage your migraine is important. Review your symptoms and triggers with your doctor. Together, you can create a treatment plan that will not only help you manage the pain when a migraine happens, but keep them from developing in the first place.

A good treatment plan should include:

  • identifying the type of migraine you have
  • identifying triggers

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When Should I Call An Ambulance

Most headaches are not serious. But headaches can also be a sign of a serious illness, such as a stroke or meningitis.

  • it comes on suddenly, is very severe, or has made you lose consciousness
  • you have suffered a head injury
  • you have trouble seeing, walking or speaking
  • your arms or legs feel numb
  • you have nausea or vomiting
  • you have a high fever
  • you are sensitive to light and have a new rash

There Are No Tests For Diagnosis

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Q: Are there any tests to diagnose headaches?

A: These are clinical diagnoses, meaning the diagnosis is being made largely based on history. There’s no test for these. The test would be simply to exclude other causes for headaches. Usually not required, but in some cases when there’s uncertainty, there are other tests such as imaging, but the imaging would be normal in these three diagnoses. Its really up to the clinicians ability to take a careful history to tease out the different causes of headache. Often times it’s when we take a history it’s evident within the first couple of sentences. We start talking to a patient within a minute or two, we have a pretty good idea of what the diagnosis is. The other features I mentioned are to be nothing else which we would be entertaining.

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Can Using Birth Control Pills Make My Migraines Worse

In some women, birth control 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.

When Are They Not Helpful

Migraine attacks can last for hoursor even days. They can cause intense pain, nausea and vomiting. They can make you sensitive to light or noise and they can affect your life and work.

To treat migraines, you may be given a prescription for an opioid or a barbiturate called butalbital. These are pain medicines. But you should think twice about using these drugs for migraine. Heres why:

These drugs can make headaches worse.

Using too much pain medicine can lead to a condition called medication overuse headache . Two kinds of pain medicine are more likely to cause MOH:

  • Drugs containing opioidssuch as codeine , morphine , Hycodan or oxycodone .
  • Drugs containing butalbital .

They are not as effective as other migraine drugs.

There are other drugs that can reduce the number of migraines you have and how severe they arebetter than opioids and butalbital. Even in the emergency roomwhere people with severe migraines often ask for opioidsbetter drugs are available, including triptans.

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Triptans And Ergot Alkaloids

The 2 categories of migraine-specific oral medications are triptans and ergot alkaloids. The specific ergot alkaloids include ergotamine and dihydroergotamine . The specific triptans include the following:

  • Sumatriptan

  • Eletriptan

  • Frovatriptan

Although the triptans share a common mechanism of action, they differ in the available routes of administration, onset of action, and duration of action. Routes of administration include oral, intranasal, subcutaneous, and intramuscular. Transdermal patches have proved effective for the delivery of sumatriptan, and one such product has received FDA approval. The sumatriptan iontophoretic transdermal system was approved by the FDA in January 2013 for the acute treatment of migraine with or without aura in adults. The single-use patch also treats migraine-related nausea. In phase 3 trials involving 800 patients, the patches safely and effectively relieved migraine pain, migraine-related nausea, sonophobia, and photophobia within 2 hours of activation.

The FDA approved a low-dose intranasal sumatriptan powder for migraine in January 2016. The product consists of 22 mg of sumatriptan powder and is the first breath-powered intranasal medication delivery system to treat migraines. Approval was based on data from phase 2 and phase 3 trials, reference data on the use of sumatriptan, and safety data from more than 300 patients.

When To Go To The Emergency Room For A Headache Or Migraine

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Headache is one of the most common reasons for an emergency room visit. Some people go due to chronic headache or Migraine problems that do not go away with treatment, and in other cases, headache is a symptom of another medical problem.

The best reason for an ER visit is for unusual symptoms that are new to you. You may seek attention to make sure there is no chance of another problem such as aneurysm or meningitis. A severe headache that starts very suddenly can mean another disorder such as stroke.

New symptoms such as a fever, weakness, vision loss or double vision, or confusion are some of most concerning symptoms. If you have a new symptom and serious, life-threatening medical problems such as liver, heart or kidney disease, are pregnant, or have a disorder that affects your immune system such as HIV infection, an ER visit may be more essential.

For many patients, an ER visit for headache or Migraine happens after a long period of severe headache lasting days or weeks. After long time of experiencing severe headaches, you may reach the last straw and no longer be able to deal with the problem.

ER doctors are not specialists in headache and Migraine, and their goals are to make sure there is no serious, life-threatening problem and help reduce suffering. Different ER doctors have different ways to treat acute headaches and Migraine: there is no universal protocol for emergency treatment of headache disorders.

When going to the ER, be sure to mention:

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Whats A Migraine What Does It Feel Like

A migraine is more than a bad headache. Its a neurologic disease with a series of symptoms that might include debilitating pain on one side of your head that you may describe as pulsing or throbbing. Menstrual migraines, also known as hormone headaches, happen right before or during a womans period and may get worse with movement, light, smells, or sound. Your symptoms may last for a few hours, but theyll likely last days.

Its estimated that 70% of people who experience migraines are women. Of these women, 60% to 70% report a connection between their menstruation and their migraine attacks. Women experience migraine attacks three times more frequently than men.

A menstrual migraine is one of several types of migraine headaches. Examples of other migraines include migraine with aura, migraine without aura and chronic migraine.

Acute Migraine Headache: Treatment Strategies

LAURA MAYANS, MD, MPH, and ANNE WALLING, MB, ChB, University of Kansas School of Medicine, Wichita, Kansas

Am Fam Physician. 2018 Feb 15 97:243-251.

Patient information: A handout on this topic is available at .

Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line treatments for mild to moderate migraines, whereas triptans are first-line treatments for moderate to severe migraines. Although triptans are effective, they may be expensive. Other medications such as dihydroergotamine and antiemetics are recommended for use as second- or third-line therapy for select patients or for those with refractory migraine. The pharmacologic properties, potential adverse effects, cost, and routes of administration vary widely, allowing therapy to be individualized based on the pattern and severity of attacks. Several treatment principles, including taking medication early in an attack and using a stratified treatment approach, can help ensure that migraine treatment is cost-effective.

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What Are Hormones What Is Estrogen

Hormones are often called your bodys chemical messengers. Theyre in your organs, tissues and bloodstream and theyre made by the endocrine glands. Examples of endocrine glands include your thyroid gland, adrenal glands and pituitary gland. If you have too little of a certain hormone, or too much, that can throw your entire system off balance.

Estrogen and progesterone are the two main sex hormones in women. Estrogen causes female physical features, sets off puberty and aids with reproduction. It also affects your cholesterol, controls your menstrual cycle, protects bone health and affects your heart, skin, bones, brain and other tissues. Its mostly produced by your ovaries.

Your levels of estrogen change. Theyre at the highest amount in the middle of your cycle and the lowest amount when youre on your period. When youre in menopause, they drop very low.

Reduction Of Migraine Triggers

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Patients should avoid factors that precipitate a migraine attack . Encourage patients to use a daily diary to document the headaches. This is an effective and inexpensive tool to follow the course of the disease.

Patients may need to discontinue any medications that exacerbate their headaches. If an oral contraceptive is suspected to be a trigger, the patient may be advised to modify, change, or discontinue its use for a trial period. Similarly, when hormone replacement therapy is a suspected trigger, patients should reduce dosages, if possible. If headaches persist, consider discontinuing hormone therapy.

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Bonus: Learn And Build

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Between attacks is a good time to educate yourself and build a support system to help you through the next one.

  • Educate yourself on head pain causes, symptoms, and treatments. It’ll allow you to better care for yourself and understand what your healthcare provider says about your condition and treatment.
  • Keep a daily headache and migraine diary including what you eat, activities, and other factors that may lead to head pain. It can take up to 48 hours for a trigger to cause a headache or migraine, so a careful diary may help reveal patterns.
  • Find a support group in your community or online so you have understanding people to vent to and learn from. You’ll feel less alone and could pick up valuable information.

Tips To Ease Migraine Pain

Even if you avoid triggers and practice healthy habits, you may still experience migraine attacks. Here are some home remedies that might bring relief.

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When a migraine attack sets in, all you want is relief. For some people, taking migraine medication can help ease the pain, says , an associate professor of neurology at the University of Maryland Medical Center in Baltimore.

But is there anything else you can do to help shorten the attack or make the symptoms more bearable until the medication starts to work?

If youre in need of migraine first aid, try the following suggestions. Most of these interventions are free and come with no side effects.

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What Can I Do To Prevent Migraines

One of the best ways to prevent migraines is to try to avoid the things that might trigger your attacks. Most people benefit from trying to get stable sleep, eating regular meals, drinking plenty of fluids to keep hydrated, and trying to manage stress. Taking regular exercise may also help prevent migraines since it helps with breathing, improving blood sugar balance and maintaining general wellbeing. Although you should take care not to engage in very strenuous activity that your body is not used to as this can sometimes act as a migraine trigger.

Keeping a diary of your migraines can be a useful way to record when and where you experience attacks, check for any patterns, and try to identify your triggers. Take the diary when you see your GP so you can communicate your symptoms with them and they can find the best way to help you.

Prevent Attacks With Exercise

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Exercising during a migraine attack can make the pain worse, but exercising between attacks may help to reduce the number of attacks you have.

Contrary to popular belief, exercise wont trigger a migraine in most people, says Dale Bond, PhD, a professor of psychiatry and human behavior at The Miriam Hospital and Brown Alpert Medical School in Providence, Rhode Island.

In terms of aerobic exercise, we would generally tell our patients to start with walking its easy, its safe, its cheap, and its practical and to do that regularly, says Bond.

That may reduce migraine and prevent migraine attacks through physiological mechanisms for example, by reducing inflammation and improving cardiovascular health, he says.

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