Migraine Headaches

What Causes Migraines? One theory is that certain events or substances (triggers) can set off an imbalance of naturally occurring chemicals such as serotonin. Serotonin plays many roles in the body and it can have an effect on the blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). As shown in the graphic, the area around these blood vessels becomes inflamed and irritates nerve endings. This dilation (expansion) and irritation may account for the throbbing pain you experience in your temple or behind your eye.

The chemical imbalance theory is not the only one. Some Investigators now believe that migraine may be caused by inherited abnormalities in certain cell populations in the brain. Using new imaging technologies, scientists can see changes in the brain during migraine attacks. According to the National Institute of Neurological Disorders and Stroke, Scientists believe that there is a migraine pain center located in the brainstem, a region at the base of the brain. As neurons fire, surrounding blood vessels dilate and become inflamed, causing the characteristic pain of a migraine.

Migraine Facts: Migraine headaches are less common than tension-type headaches. Nevertheless, migraines afflict 25 to 30 million people in the United States alone.

As many as 6% of all men and up to 18% of all women (about 12% of the population as a whole) experience a migraine headache at some time.
Roughly three out of four migraine sufferers are female.
Among the most distinguishing features is the potential disability accompanying the headache pain of a migraine. The simple act of moving may be difficult and pain may be aggravated or worsen from any activity.
Migraines are felt on one side of the head by about 60% of migraine sufferers and the pain is typically throbbing in nature - as though one’s pulse is beating severely in the head. The pain usually begins at the temple and can spread downward to the eye, face and neck.
Nausea, with or without vomiting, as well as sensitivity to light, sound and certain odors often accompany migraines.
Auras - a group of telltale neurological symptoms - sometimes occur before the head pain begins. Typically, an aura involves a disturbance in vision that may consist of brightly colored or blinking lights in a pattern that moves across the field of vision. A loss of sensation in one or more body parts or even loss of speech can occur. About one in five migraine headache sufferers experiences an aura.
Ophthalmic migraine - Some people experience flashes of light that appear as jagged lines or "heat waves" in both eyes, often lasting 10-20 minutes. If a headache follows the flashes, it is called a migraine headache. However, jagged lines or "heat waves" can occur without a headache. In this case, the light flashes are called ophthalmic migraine or migraine without headache.
Usually, migraine attacks are occasional, or sometimes as often as once or twice a week.

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How are migraines related to menstruation? Menstrual migraines have been related to the drop in the female hormone, estrogen, immediately before the start of the menstrual flow. Doctor Brian Somerville noted that premenstrual migraine regularly occurred during or after the time when the female hormones, estrogen and progesterone, decreased to their lowest levels.

What are some migraine triggers in women? Birth control pills as well as hormone replacement therapy during menopause have been recognized as migraine triggers. As early as 1966, investigators noted that migraine can become more severe with birth control pills containing high doses of estrogen.

What are the treatment options for menstrual migraine? The medications of choice in the treatment of menstrual migraine are NSAIDS. Therapy with the NSAID should be started 2 to 3 days before the onset of the menstrual flow (menses) and continued through the flow. Because the therapy is of short duration, the risk of gastrointestinal effects is limited.

General Treatment: Headaches can be managed with proper medication, diet, exercise and lifestyle modification. When headaches occur occasionally (one time a week), over-the-counter medications, a "time out" for relaxation or a short nap will likely provide pain relief. In fact, most people with occasional headaches will select a nonprescription "over-the-counter" (OTC) pain reliever from their pharmacy or supermarket shelves.

Available without prescription, OTC pain relievers contain powerful, effective ingredients. There are several different groups of OTC pain relievers including combination products:

Aspirin products
Acetaminophen products
NSAIDs such as ibuprofen and naproxen sodium products
Combination products such as those that contain OTC pain relievers and caffeine

Each group has specific advantages and side effects. The most appropriate way to
select a medication or combination of medications is to weigh the desired effect against potential side effects. Most OTC pain relievers are available in tablets, caplets and geltabs. While all forms of a medication are equally effective, some may be easier to swallow than others.

Note: If you take medications for any other medical condition (such as high blood pressure, arthritis, diabetes, ulcers or even acne) be sure to check with your physician
or pharmacist before taking an OTC pain reliever. It is important to make certain that adding a pain reliever to the medicines you already take will not result in undesirable
drug interactions.

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Sources:

1) American Academy of Family Physicians 1) American Stroke Association 1) The Cleveland Clinic