Around 10 to 14 percent of all women suffer from menstruation-associated migraines. A special consultation for hormonal migraines at the USZ offers treatment options.
Headaches and migraines in particular occur more frequently in women than in men. But not because women are more snivelling. Up until puberty, migraines are equally common among girls and boys, but the frequency shifts thereafter, and women are affected three times more often than men. After the menopause, the ratio changes again; fewer women then suffer from migraines, but still around twice as many as men.
Women are more prone to migraines
Gynecologist Gabriele Merki has dealt intensively with the topic of hormonal migraine in her clinical work and in research. She is a migraine specialist and heads the consultation for hormone-dependent migraine at the Clinic for Reproductive Endocrinology at the USZ. “The drop in oestrogen, i.e. the female sex hormones, before the menstrual period plays an important role in menstrual migraines,” she explains. “But contraceptives containing oestrogen can also trigger or worsen migraines in women who are susceptible to them.” During pregnancy and after the menopause, there is no longer a drop in oestrogen; migraine attacks then occur less frequently in many women or the migraine disappears completely.
Correctly recognize migraines and accompanying illnesses
“It’s not always easy to distinguish migraines from normal headaches,” says Gabriele Merki. “However, careful clarification is the basis for effective treatment.” This requires patients to keep a specially developed, detailed diary for at least two months, in which they record, among other things, when and during which activity headaches occurred, how long they lasted, what intensity of pain they felt and whether and which accompanying symptoms were associated with the headaches. 10 to 20 percent of migraine patients suffer from depression or endometriosis in addition to migraines. “For successful treatment, it is important to recognize these additional diseases and to adapt the therapy accordingly,” explains Gabriele Merki.
Advantages of headache treatment at the USZ
In the headache consultation at the Clinic for Neurology, you will receive expert advice and treatment of your headaches according to modern therapy standards.
In regular interdisciplinary meetings with experts from other specialist disciplines (e.g. anesthesiology, rheumatology, psychiatry, psychosomatics, neurosurgery, oral and maxillofacial surgery, physiotherapy), we can find a solution that suits you, even in difficult cases. We are happy to support you.
Individually tailored therapy
After the assessment, Gabriele Merki discusses the treatment options with her patients. “Menstrual migraines in particular do not respond to the usual migraine medication,” she explains. On the other hand, special hormones can also reduce the number of non-menstrual migraine attacks. Menstrual migraines can often be treated with certain luteal hormone preparations or by preventing the drop in hormones at the end of the cycle.
It is important to clarify possible risks before treatment and to minimize them with the appropriate treatment. Migraine patients have an increased risk of stroke, especially those who suffer from migraine attacks with an aura, i.e. attacks that are associated with perceptual or sensory disturbances. Gabriele Merki therefore works closely with the specialists from the interdisciplinary headache consultation and the Department of Neurology at the USZ to make a diagnosis and determine the best treatment for the patient.
A holistic approach to migraines
Migraines can lead to incapacity to work. The disease and the associated psychological stress can have an enormous impact on quality of life. Gabriele Merki focuses on holistic treatment. In addition to proven drug therapy, relaxation techniques and exercise can also be helpful supplements. A physiotherapy team specializing in headaches and migraines is available at the USZ for this purpose.