Migraine associated with the menstrual cycle afflicts most women
Menstrual migraine is common to approximately 60% of women with migraine. Fluctuating hormonal levels account to some extent for the higher prevalence of migraine among women than among men. Two-thirds to three-fourths of all migraine sufferers are female.
However, the incidence of migraine in the pediatric population is higher among boys than girls. With puberty, the percent of boys with migraine decreases, whereas that of females with migraine increases.
Some researchers and clinicians make a distinction between “menstrually associated migraine” (MAM – sometimes called menstrually related migraine) and ‘true’ menstrual migraine. In the former, migraine may occur at any time of the month, but is more frequent at or around the time of menstruation. In the latter, migraine exclusively occurs at or around the time of menstruation.
The distinction does not appear to be clinically relevant. In either case, migraine at time of menstruation is widely recognized as being more difficult to treat, of longer duration, and generally more painful than migraine not associated with menstruation.
Summary of the abstract
The frequency of migraine increases in females at adolescence.
Exaggerated or abnormal neurotransmitter responses to normal cyclic changes in the ovarian hormones are probably the basic cause of menstrual migraines. The fall in estrogen levels during menstrual cycle is a trigger for the menstrual migraine. In menstrual migraine the pain is stronger, and it lasts longer than in other types of migraines. Also, menstrual migraines are more difficult to treat than other types of migraines.
A decline in estrogen levels at the end of the menstrual cycle is believed to trigger migraine.