1) A menstrual migraine is a migraine that occurs regularly before or during a woman's menstrual period and is triggered by fluctuations in hormone levels, particularly drops in estrogen.
2) Treatment involves both acute approaches like NSAIDs and triptans to stop migraines once they start, as well as preventive approaches like hormonal therapies or oral contraceptives that aim to reduce the estrogen drop and prevent migraines.
3) Lifestyle modifications including proper sleep, diet, exercise, stress management, and avoiding triggers can also help reduce menstrual migraines.
Migraine treatment involves both acute and preventative therapy, with the goals of stopping progression of headaches, reducing frequency and severity of attacks, and improving quality of life. Treatment options include over-the-counter pain relievers, prescription medications like triptans and ergot alkaloids, and non-pharmacological therapies like biofeedback and relaxation. Emergency care focuses on providing symptomatic relief and appropriate medications.
This document provides an overview of insomnia and a yogic approach to treating it. It defines insomnia as a sleep disorder making it difficult to fall or stay asleep. The document then discusses the types, causes, symptoms, risk factors, and conventional medical treatments and side effects of insomnia. It proposes that yoga can help treat insomnia by relaxing the body and mind through asanas, pranayama, meditation, and relaxation techniques. It explains how yoga addresses the root causes of insomnia according to various yoga philosophies like the koshas, panchavimsati, and tridosha theories. The document concludes that following a yogic lifestyle with discipline can cure insomnia and its underlying causes better than conventional medical treatments alone.
Introduction to depression and antidepressant agentsDomina Petric
Major depressive disorder is characterized by depressed mood or loss of interest for at least two weeks and is associated with disturbances in sleep, appetite, cognition, and energy. Depression is also linked to increased risk of medical conditions like heart disease and diabetes. While the causes are not fully known, hypotheses include deficits in monoamine neurotransmitters like serotonin and norepinephrine as well as reductions in neurotrophic factors associated with neuronal growth and survival. Effective antidepressants may work by enhancing monoamine levels and increasing neurotrophic support in brain areas like the hippocampus.
Migraines affect almost 30 million Americans each year, occurring more commonly in women than men. Migraines are a neurological disorder that causes severe pulsating head pain on one side of the brain along with sensitivity to light, sound, and smells. Symptoms include moderate to severe headache pain, nausea, vomiting, and visual disturbances. Triggers vary between individuals but common ones are stress, foods containing tyramine, allergies, dehydration, and changes in sleep or diet. Treatment depends on migraine type, severity, and frequency and may include abortive medications to stop attacks or preventative medications and lifestyle changes to reduce attack frequency.
Topiramate has been shown to be an effective preventive treatment for migraine in multiple randomized controlled trials. It significantly reduced monthly migraine frequency compared to placebo at doses of 100mg and 200mg per day. Around 50% of patients achieved at least a 50% reduction in migraine days. The onset of efficacy was seen within the first month of treatment. Topiramate is generally well-tolerated, with dose titration helping to manage potential side effects. It offers an important additional option for preventing debilitating migraines.
Migraine is characterized by episodic headaches that are typically unilateral and associated with symptoms like nausea, visual disturbances, photophobia, and phonophobia. It is believed to originate from changes in brain nerve cell activity and blood flow which can cause visual symptoms prior to headache onset. Treatment involves identifying and avoiding triggers, using over-the-counter pain relievers during attacks, and preventive medications if attacks occur frequently. Triptans and ergotamine are prescribed for acute attacks while beta-blockers and antidepressants are common preventive options.
Migraines are severe, debilitating headaches that are usually characterized by an intense throbbing or pulsing in one area of your head. They can include sensitivity to light, sound, and smell, create visual disturbances such as auras, and can even cause nausea or vomiting. They are more than a headache and can affect your everyday life.
Major depression is a mood disorder characterized by depressed mood or loss of interest in activities. It is estimated that over 300 million people worldwide suffer from depression. Treatment involves psychotherapy such as cognitive behavioral therapy and antidepressant medication. There are several classes of antidepressants including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and atypical antidepressants. SSRIs are now the first-line treatment due to their favorable side effect profile compared to other antidepressants. Research is also being conducted to develop new antidepressant drugs with novel mechanisms of action.
Migraine treatment involves both acute and preventative therapy, with the goals of stopping progression of headaches, reducing frequency and severity of attacks, and improving quality of life. Treatment options include over-the-counter pain relievers, prescription medications like triptans and ergot alkaloids, and non-pharmacological therapies like biofeedback and relaxation. Emergency care focuses on providing symptomatic relief and appropriate medications.
This document provides an overview of insomnia and a yogic approach to treating it. It defines insomnia as a sleep disorder making it difficult to fall or stay asleep. The document then discusses the types, causes, symptoms, risk factors, and conventional medical treatments and side effects of insomnia. It proposes that yoga can help treat insomnia by relaxing the body and mind through asanas, pranayama, meditation, and relaxation techniques. It explains how yoga addresses the root causes of insomnia according to various yoga philosophies like the koshas, panchavimsati, and tridosha theories. The document concludes that following a yogic lifestyle with discipline can cure insomnia and its underlying causes better than conventional medical treatments alone.
Introduction to depression and antidepressant agentsDomina Petric
Major depressive disorder is characterized by depressed mood or loss of interest for at least two weeks and is associated with disturbances in sleep, appetite, cognition, and energy. Depression is also linked to increased risk of medical conditions like heart disease and diabetes. While the causes are not fully known, hypotheses include deficits in monoamine neurotransmitters like serotonin and norepinephrine as well as reductions in neurotrophic factors associated with neuronal growth and survival. Effective antidepressants may work by enhancing monoamine levels and increasing neurotrophic support in brain areas like the hippocampus.
Migraines affect almost 30 million Americans each year, occurring more commonly in women than men. Migraines are a neurological disorder that causes severe pulsating head pain on one side of the brain along with sensitivity to light, sound, and smells. Symptoms include moderate to severe headache pain, nausea, vomiting, and visual disturbances. Triggers vary between individuals but common ones are stress, foods containing tyramine, allergies, dehydration, and changes in sleep or diet. Treatment depends on migraine type, severity, and frequency and may include abortive medications to stop attacks or preventative medications and lifestyle changes to reduce attack frequency.
Topiramate has been shown to be an effective preventive treatment for migraine in multiple randomized controlled trials. It significantly reduced monthly migraine frequency compared to placebo at doses of 100mg and 200mg per day. Around 50% of patients achieved at least a 50% reduction in migraine days. The onset of efficacy was seen within the first month of treatment. Topiramate is generally well-tolerated, with dose titration helping to manage potential side effects. It offers an important additional option for preventing debilitating migraines.
Migraine is characterized by episodic headaches that are typically unilateral and associated with symptoms like nausea, visual disturbances, photophobia, and phonophobia. It is believed to originate from changes in brain nerve cell activity and blood flow which can cause visual symptoms prior to headache onset. Treatment involves identifying and avoiding triggers, using over-the-counter pain relievers during attacks, and preventive medications if attacks occur frequently. Triptans and ergotamine are prescribed for acute attacks while beta-blockers and antidepressants are common preventive options.
Migraines are severe, debilitating headaches that are usually characterized by an intense throbbing or pulsing in one area of your head. They can include sensitivity to light, sound, and smell, create visual disturbances such as auras, and can even cause nausea or vomiting. They are more than a headache and can affect your everyday life.
Major depression is a mood disorder characterized by depressed mood or loss of interest in activities. It is estimated that over 300 million people worldwide suffer from depression. Treatment involves psychotherapy such as cognitive behavioral therapy and antidepressant medication. There are several classes of antidepressants including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and atypical antidepressants. SSRIs are now the first-line treatment due to their favorable side effect profile compared to other antidepressants. Research is also being conducted to develop new antidepressant drugs with novel mechanisms of action.
Migraine is a recurrent headache disorder characterized by attacks of moderate to severe pain that is typically pulsating, lasting 4-72 hours and occurring on one side of the head. There are two main types - migraine without aura which involves headache only and migraine with aura which includes neurological symptoms prior to headache. Migraine involves distinct phases including prodrome, aura, headache and postdrome. It is more prevalent in females and peaks between ages 25-55. Management involves identifying triggers, lifestyle modifications, and acute or preventive pharmacological therapies like triptans, NSAIDs, beta-blockers or anti-convulsants.
Migraine pathophysiology, diagnosis and treatmentsYung-Tsai Chu
Introduction of migraine, including symptoms, epidemiology, pathophysiology(neurotransmitter, neural network, channel, CGRP), diagnostic criteria and treatment (oral, intravenous therapy at ED and long-term prevention)
A 35-year-old female patient has been experiencing recurrent severe headaches over the last 4 months, with unilateral pulsating pain lasting over 6 hours accompanied by nausea and sometimes vomiting. She prefers sitting in a dark room during attacks and is unable to be active. Migraine should be suspected in patients presenting with recurrent headaches that are unilateral, pulsating, long-lasting and inhibit daily activities, especially in women aged 20-50. Migraine is characterized by moderate to severe throbbing headache on one side of the head and can present with aura, nausea, photophobia, phonophobia, or other neurological symptoms. Treatment involves managing acute attacks and considering prophylaxis for frequent episodes.
This document provides an overview of migraines including:
- Migraines affect 10-20% of the general population and are characterized by recurrent attacks of headache that vary in intensity and duration.
- Triggers include disturbed sleep, hormones, drugs, exertion, and sensory or weather stimuli. Attacks progress through prodrome, aura, headache, and postdrome phases.
- Treatment involves avoiding triggers, acute abortive medications like triptans for pain relief, and preventive medications if attacks are frequent or debilitating to reduce severity and frequency.
- Both pharmacological and non-pharmacological approaches are used to manage migraines, establish diagnoses, educate patients, and improve quality of life
learning objective includes : pathogenesis,clinical features, classification of migraine, pharmacology about specific antimigraine drugs, coverage to newer triptan- Lasmiditan and newer prophylactic drug Erenumab a CGRP receptor antagonist.
ECT involves inducing seizures through electric currents to treat severe mental illnesses like depression. It requires anesthesia and muscle paralysis during treatment. While fast-acting, it carries risks of memory loss and physical side effects. Individual psychotherapy explores one's feelings through a therapeutic relationship, while group therapy involves learning from shared experiences in a structured setting.
This document provides information on various therapeutic modalities and psychosocial interventions including electroconvulsive therapy (ECT), psychotherapies, group therapies, and biophysical interventions. It describes the procedures, indications, contraindications, advantages, and disadvantages of ECT. It also discusses individual psychotherapy, group therapy, family therapy, education groups, support groups, and self-help groups.
This document provides guidelines for the management and treatment of migraines. It discusses various drug options for acute/abortive treatment, preventative treatment, and treatment of refractory cases. It also addresses special considerations for medication overuse headache, menstrual migraine, and pregnancy-related migraine management. Non-pharmacological options including behavioral therapies and physical treatments are also summarized. Recent developments involving CGRP antagonists as a new drug class for migraine prevention are mentioned.
My own slim attempt at covering the extremely complex and ever evolving field of migraine pathophysiology. Not intended by any means to be exhaustive but more like a unique take and beginner's guide.
This document provides information on the management of migraines. It defines migraines and discusses their prevalence, burden, triggers, phases, and classification. It also covers the pathophysiology of migraines and outlines approaches to diagnosis, abortive treatment, and preventive treatment including medications like propranolol. Propranolol is positioned as the gold standard preventive treatment and its mechanisms of action, formulations, efficacy, dosage, and advantages over immediate-release versions are detailed.
Migraine is a common type of headache characterized by severe throbbing pain, nausea, and sensitivity to light and sound. It is believed to be caused by swelling of blood vessels in the brain and is more common in women. Symptoms include headaches lasting 4-12 hours that may be preceded by visual disturbances. Treatment involves managing triggers to prevent headaches and using over-the-counter or prescription medications to stop headaches once they start or reduce their frequency. While migraines often continue for many years, symptoms typically lessen for most people after age 50-60.
This document summarizes the pharmacotherapy of migraine. It outlines the pathophysiology including vascular, neurogenic, and neurovascular theories. It discusses acute treatment with non-specific medications like NSAIDs and specific treatments like triptans. Preventive treatment options are also covered including antidepressants, beta-blockers, anti-epileptics, calcium channel blockers, and newer targets such as CGRP antagonists and nitric oxide synthase inhibitors.
Migraines are severe headaches often preceded by sensory warning signs like flashes of light and nausea. They have been documented for over 7,000 years and theories about their cause have evolved from humors rising in the body to increased blood flow in the brain. Migraines involve four phases - prodrome, aura, headache, and postdrome. Current theories suggest they are caused by cortical spreading depression leading to neurogenic inflammation and vascular changes in the brain. Treatment involves avoiding triggers, medications like triptans to abort attacks, and preventative medications like beta blockers, antidepressants, or anti-seizure drugs to reduce frequency.
Migraine is a neurological disorder characterized by recurrent headaches that are often severe and pulsating in nature. It is estimated to affect 10% of the worldwide population. There are two main types - migraine with aura, which involves neurological symptoms before or during the headache, and migraine without aura, which involves headaches without preceding neurological symptoms. Potential triggers include hormonal changes, stress, foods, and environmental factors like light and noise. Management involves lifestyle modifications and medications to abort acute attacks or prevent future attacks. Preventive medications include beta blockers, antidepressants, and anti-seizure drugs, while acute treatments include analgesics, triptans, and anti-nausea drugs.
This document provides information on migraine including classification, pathophysiology, treatment of acute attacks, and preventive therapy. It notes that migraine is a recurrent headache disorder characterized by attacks lasting 4-72 hours with symptoms like throbbing pain and sensitivity to light/sound. Treatment involves analgesics, triptans, or ergot derivatives for acute attacks and medications like propranolol, amitriptyline or topiramate for prevention. The pathophysiology involves dilatation and constriction of cranial blood vessels triggered by the trigeminal nerve.
Brain Chemistry And The Medical Treatment Of Major DepressionGiakas
This document discusses the biological basis and treatment of major depression. It covers the challenges in diagnosis and treatment selection. The roles of neurotransmitters like serotonin, norepinephrine, and dopamine are explained. Different medication options are presented, including single-action antidepressants, multi-action antidepressants, and augmentation strategies. Research focuses on the hippocampus and neuroplasticity changes related to depression. Antidepressants may work by upregulating neurotrophic factors and the CREB cascade to promote neurogenesis. Electroconvulsive therapy and vagus nerve stimulation are also reviewed as effective treatment options.
The document discusses the management of migraines. Key points include:
- Migraines are a common cause of recurrent headaches affecting 10-20% of the population. They are often underdiagnosed and undertreated.
- Treatment involves both abortive and preventive therapies. Common abortive medications include NSAIDs, triptans, and ergot alkaloids. Preventive options include beta-blockers like propranolol, antidepressants, anti-seizure medications, and calcium channel blockers.
- Propranolol, especially the extended release formulation, is an effective and well-tolerated option for migraine prevention and reduces attack frequency, severity, and analgesic use
Recent Advances in Pharmacotherapy of MigraineHtet Wai Moe
Recent Advances in Pharmacotherapy of Migraine
- Migraine is a neurological disorder characterized by recurrent headache attacks associated with nausea, vomiting, and sensitivity to light and sound.
- New acute and preventive treatment options include CGRP antagonists, 5-HT1F agonists, glutamate receptor antagonists, and orexin receptor antagonists.
- Existing drugs such as dexamethasone, carvedilol, tiagabine, levetiracetam, zonisamide, and tizanidine have shown promise for preventive treatment when used off-label.
- Medical devices like Cerena, Cefaly, and Gamma Core provide non-drug options for acute or
Migraine its presentation and managementdrmohitmathur
This document summarizes information about migraines including what they are, common symptoms, triggers, types (aura vs without aura), overuse of medications leading to chronic migraines, management through lifestyle changes and medications, and resources for more information. Migraines involve recurrent attacks of moderate to severe headaches that can last hours to days, often accompanied by nausea, sensitivity to light/sound, and visual disturbances prior to pain for those with aura. Management focuses on avoiding triggers through lifestyle modifications, medications as directed by a doctor, and self-care techniques like rest, heat/ice, and biofeedback.
1. The female menstrual cycle involves complex interactions between hormones and organ systems over roughly 30-40 years.
2. Menstruation can cause discomfort for some women and be disrupted by many factors like stress, medications, infections and diseases.
3. Menopause is a natural biological process when ovulation and menstruation cease between ages 45-55, bringing hormonal changes that result in symptoms for some women like hot flashes and mood swings. Cupping therapy applied to the genital area can help stabilize results.
This document summarizes various gynecological disorders including menstrual disorders, amenorrhea, abnormal uterine bleeding, menstrual pain, endometriosis, premenstrual disorders, gynecological infections including toxic shock syndrome, sexually transmitted infections, and pelvic inflammatory disease. It provides details on causes, symptoms, diagnoses, and treatment for each condition. The nursing role involves educating patients, explaining treatments, providing emotional support, and preventing infections through measures like safe sex practices and hygiene.
Migraine is a recurrent headache disorder characterized by attacks of moderate to severe pain that is typically pulsating, lasting 4-72 hours and occurring on one side of the head. There are two main types - migraine without aura which involves headache only and migraine with aura which includes neurological symptoms prior to headache. Migraine involves distinct phases including prodrome, aura, headache and postdrome. It is more prevalent in females and peaks between ages 25-55. Management involves identifying triggers, lifestyle modifications, and acute or preventive pharmacological therapies like triptans, NSAIDs, beta-blockers or anti-convulsants.
Migraine pathophysiology, diagnosis and treatmentsYung-Tsai Chu
Introduction of migraine, including symptoms, epidemiology, pathophysiology(neurotransmitter, neural network, channel, CGRP), diagnostic criteria and treatment (oral, intravenous therapy at ED and long-term prevention)
A 35-year-old female patient has been experiencing recurrent severe headaches over the last 4 months, with unilateral pulsating pain lasting over 6 hours accompanied by nausea and sometimes vomiting. She prefers sitting in a dark room during attacks and is unable to be active. Migraine should be suspected in patients presenting with recurrent headaches that are unilateral, pulsating, long-lasting and inhibit daily activities, especially in women aged 20-50. Migraine is characterized by moderate to severe throbbing headache on one side of the head and can present with aura, nausea, photophobia, phonophobia, or other neurological symptoms. Treatment involves managing acute attacks and considering prophylaxis for frequent episodes.
This document provides an overview of migraines including:
- Migraines affect 10-20% of the general population and are characterized by recurrent attacks of headache that vary in intensity and duration.
- Triggers include disturbed sleep, hormones, drugs, exertion, and sensory or weather stimuli. Attacks progress through prodrome, aura, headache, and postdrome phases.
- Treatment involves avoiding triggers, acute abortive medications like triptans for pain relief, and preventive medications if attacks are frequent or debilitating to reduce severity and frequency.
- Both pharmacological and non-pharmacological approaches are used to manage migraines, establish diagnoses, educate patients, and improve quality of life
learning objective includes : pathogenesis,clinical features, classification of migraine, pharmacology about specific antimigraine drugs, coverage to newer triptan- Lasmiditan and newer prophylactic drug Erenumab a CGRP receptor antagonist.
ECT involves inducing seizures through electric currents to treat severe mental illnesses like depression. It requires anesthesia and muscle paralysis during treatment. While fast-acting, it carries risks of memory loss and physical side effects. Individual psychotherapy explores one's feelings through a therapeutic relationship, while group therapy involves learning from shared experiences in a structured setting.
This document provides information on various therapeutic modalities and psychosocial interventions including electroconvulsive therapy (ECT), psychotherapies, group therapies, and biophysical interventions. It describes the procedures, indications, contraindications, advantages, and disadvantages of ECT. It also discusses individual psychotherapy, group therapy, family therapy, education groups, support groups, and self-help groups.
This document provides guidelines for the management and treatment of migraines. It discusses various drug options for acute/abortive treatment, preventative treatment, and treatment of refractory cases. It also addresses special considerations for medication overuse headache, menstrual migraine, and pregnancy-related migraine management. Non-pharmacological options including behavioral therapies and physical treatments are also summarized. Recent developments involving CGRP antagonists as a new drug class for migraine prevention are mentioned.
My own slim attempt at covering the extremely complex and ever evolving field of migraine pathophysiology. Not intended by any means to be exhaustive but more like a unique take and beginner's guide.
This document provides information on the management of migraines. It defines migraines and discusses their prevalence, burden, triggers, phases, and classification. It also covers the pathophysiology of migraines and outlines approaches to diagnosis, abortive treatment, and preventive treatment including medications like propranolol. Propranolol is positioned as the gold standard preventive treatment and its mechanisms of action, formulations, efficacy, dosage, and advantages over immediate-release versions are detailed.
Migraine is a common type of headache characterized by severe throbbing pain, nausea, and sensitivity to light and sound. It is believed to be caused by swelling of blood vessels in the brain and is more common in women. Symptoms include headaches lasting 4-12 hours that may be preceded by visual disturbances. Treatment involves managing triggers to prevent headaches and using over-the-counter or prescription medications to stop headaches once they start or reduce their frequency. While migraines often continue for many years, symptoms typically lessen for most people after age 50-60.
This document summarizes the pharmacotherapy of migraine. It outlines the pathophysiology including vascular, neurogenic, and neurovascular theories. It discusses acute treatment with non-specific medications like NSAIDs and specific treatments like triptans. Preventive treatment options are also covered including antidepressants, beta-blockers, anti-epileptics, calcium channel blockers, and newer targets such as CGRP antagonists and nitric oxide synthase inhibitors.
Migraines are severe headaches often preceded by sensory warning signs like flashes of light and nausea. They have been documented for over 7,000 years and theories about their cause have evolved from humors rising in the body to increased blood flow in the brain. Migraines involve four phases - prodrome, aura, headache, and postdrome. Current theories suggest they are caused by cortical spreading depression leading to neurogenic inflammation and vascular changes in the brain. Treatment involves avoiding triggers, medications like triptans to abort attacks, and preventative medications like beta blockers, antidepressants, or anti-seizure drugs to reduce frequency.
Migraine is a neurological disorder characterized by recurrent headaches that are often severe and pulsating in nature. It is estimated to affect 10% of the worldwide population. There are two main types - migraine with aura, which involves neurological symptoms before or during the headache, and migraine without aura, which involves headaches without preceding neurological symptoms. Potential triggers include hormonal changes, stress, foods, and environmental factors like light and noise. Management involves lifestyle modifications and medications to abort acute attacks or prevent future attacks. Preventive medications include beta blockers, antidepressants, and anti-seizure drugs, while acute treatments include analgesics, triptans, and anti-nausea drugs.
This document provides information on migraine including classification, pathophysiology, treatment of acute attacks, and preventive therapy. It notes that migraine is a recurrent headache disorder characterized by attacks lasting 4-72 hours with symptoms like throbbing pain and sensitivity to light/sound. Treatment involves analgesics, triptans, or ergot derivatives for acute attacks and medications like propranolol, amitriptyline or topiramate for prevention. The pathophysiology involves dilatation and constriction of cranial blood vessels triggered by the trigeminal nerve.
Brain Chemistry And The Medical Treatment Of Major DepressionGiakas
This document discusses the biological basis and treatment of major depression. It covers the challenges in diagnosis and treatment selection. The roles of neurotransmitters like serotonin, norepinephrine, and dopamine are explained. Different medication options are presented, including single-action antidepressants, multi-action antidepressants, and augmentation strategies. Research focuses on the hippocampus and neuroplasticity changes related to depression. Antidepressants may work by upregulating neurotrophic factors and the CREB cascade to promote neurogenesis. Electroconvulsive therapy and vagus nerve stimulation are also reviewed as effective treatment options.
The document discusses the management of migraines. Key points include:
- Migraines are a common cause of recurrent headaches affecting 10-20% of the population. They are often underdiagnosed and undertreated.
- Treatment involves both abortive and preventive therapies. Common abortive medications include NSAIDs, triptans, and ergot alkaloids. Preventive options include beta-blockers like propranolol, antidepressants, anti-seizure medications, and calcium channel blockers.
- Propranolol, especially the extended release formulation, is an effective and well-tolerated option for migraine prevention and reduces attack frequency, severity, and analgesic use
Recent Advances in Pharmacotherapy of MigraineHtet Wai Moe
Recent Advances in Pharmacotherapy of Migraine
- Migraine is a neurological disorder characterized by recurrent headache attacks associated with nausea, vomiting, and sensitivity to light and sound.
- New acute and preventive treatment options include CGRP antagonists, 5-HT1F agonists, glutamate receptor antagonists, and orexin receptor antagonists.
- Existing drugs such as dexamethasone, carvedilol, tiagabine, levetiracetam, zonisamide, and tizanidine have shown promise for preventive treatment when used off-label.
- Medical devices like Cerena, Cefaly, and Gamma Core provide non-drug options for acute or
Migraine its presentation and managementdrmohitmathur
This document summarizes information about migraines including what they are, common symptoms, triggers, types (aura vs without aura), overuse of medications leading to chronic migraines, management through lifestyle changes and medications, and resources for more information. Migraines involve recurrent attacks of moderate to severe headaches that can last hours to days, often accompanied by nausea, sensitivity to light/sound, and visual disturbances prior to pain for those with aura. Management focuses on avoiding triggers through lifestyle modifications, medications as directed by a doctor, and self-care techniques like rest, heat/ice, and biofeedback.
1. The female menstrual cycle involves complex interactions between hormones and organ systems over roughly 30-40 years.
2. Menstruation can cause discomfort for some women and be disrupted by many factors like stress, medications, infections and diseases.
3. Menopause is a natural biological process when ovulation and menstruation cease between ages 45-55, bringing hormonal changes that result in symptoms for some women like hot flashes and mood swings. Cupping therapy applied to the genital area can help stabilize results.
This document summarizes various gynecological disorders including menstrual disorders, amenorrhea, abnormal uterine bleeding, menstrual pain, endometriosis, premenstrual disorders, gynecological infections including toxic shock syndrome, sexually transmitted infections, and pelvic inflammatory disease. It provides details on causes, symptoms, diagnoses, and treatment for each condition. The nursing role involves educating patients, explaining treatments, providing emotional support, and preventing infections through measures like safe sex practices and hygiene.
Menstrual migraine -Management| Diagnosis| all aspects - A medical studymartinshaji
since menstrual is as common , menstrual migraine is also that much common , as this so hard to deal ...this study is all about the management of MM in detail ......this will be very useful
please comment
thank you
This document discusses mood disorders, specifically depression. It provides the DSM-IV criteria for a major depressive episode, including symptoms such as depressed mood, diminished interest, changes in appetite, insomnia, fatigue, feelings of worthlessness, difficulty concentrating, and suicidal thoughts. It also discusses treatment options, focusing on pharmacotherapy. SSRIs are considered a first-line treatment and details are provided about specific SSRIs, their mechanisms of action, indications, and precautions. Risk factors for suicide are briefly covered.
This document provides an outline on depression, antidepressant drugs, and related nursing care. It discusses types of depression like major depressive disorder and dysthymic disorder. It then covers the four main classes of antidepressant drugs - SSRIs, TCAs, atypical antidepressants, and MAOIs. For each drug class, it discusses mechanisms of action, indications, dosages, drug interactions, side effects, and relevant nursing considerations. The document aims to inform nurses on properly assessing, treating and caring for patients taking antidepressants.
You don't have to live with the side effects of having a period.
Hysteria
Irregular periods are not normal.
Bleeding long after your period ends is not normal.
Menstrual migraines are not normal.
Debilitating periods are not normal.
Long considered "Women's oldest hygenic problem".
This document discusses premenstrual changes (PMCs), also known as premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). PMCs are common cyclic affective disorders affecting young and middle-aged women, characterized by mood and physical symptoms in the luteal phase prior to menstruation. Mild symptoms affect 30-80% of women, while severe symptoms affect 3-5%. The exact causes are unclear but likely involve serotonin and hormonal fluctuations. Diagnosis involves tracking symptoms over at least two cycles to identify cyclic patterns. Treatment options range from lifestyle modifications to pharmacotherapy depending on symptom severity.
"Management of Premenstrual Tension (PMT)"
PMT (Premenstrual Tension) or PMDD (Premenstrual Dysphoric Disorder) is common problem.
Its impact on women's lives, family life in big way emphasizing the need for effective management.
The document discusses dysmenorrhoea (painful menstruation) and premenstrual syndrome (PMS). It describes the different types of dysmenorrhoea, causes, symptoms, diagnosis and treatment options. For PMS, it covers the diagnostic criteria, potential underlying causes, theories around progesterone sensitivity, and treatment approaches including lifestyle changes, supplements, SSRIs and cycle suppression methods.
This document discusses different types of headaches and their treatment. It begins by defining primary and secondary headaches. Primary headaches include tension headaches, migraines, and cluster headaches. Migraines can be triggered by various factors and cause nausea. Secondary headaches have an underlying cause like head trauma. Treatment discussed includes acetaminophen, NSAIDs, and lifestyle changes. Medication overuse headaches are also addressed. The document provides guidance on treating specific headache types and exclusions for self-treatment.
This document discusses several reproductive disorders in women including menopause, premenstrual syndrome, dysmenorrhea, amenorrhea, menorrhagia, metrorrhagia, abortion, spontaneous abortion, and habitual abortion. It describes the symptoms, causes, medical management, and nursing care considerations for each condition. Key points covered include the hormonal changes that occur during menopause and how it is signaled, common symptoms of premenstrual syndrome, painful menstruation associated with dysmenorrhea, and definitions and types of abortion.
Major Depressive Disorder is characterized by one or more episodes of depression without a history of mania. Its etiology is complex with several factors like genetics, environment, and biology contributing. Symptoms include decreased levels of neurotransmitters like serotonin and norepinephrine. Treatment involves pharmacological therapies like SSRIs, TCAs, and MAOIs to reduce symptoms as well as psychotherapy. The goals are to reduce acute symptoms, facilitate a return to normal functioning, and prevent future episodes. Treatment is conducted over acute, continuation, and maintenance phases.
The document discusses mood disorders like depression and the criteria for major depressive episodes according to the DSM-IV-TR. It then covers treatment options like pharmacotherapy, noting that SSRIs are usually the first choice medication due to their safety profile. Finally, it discusses risk factors for suicide like mental illness, depression, and substance abuse issues.
The document discusses mood disorders like depression and the criteria for diagnosing major depressive episodes. It then covers treatment options like pharmacotherapy, focusing on selective serotonin reuptake inhibitors (SSRIs) as a first-line treatment. SSRIs are generally well-tolerated but can cause side effects like sexual dysfunction, nausea, headaches, and insomnia. Precautions are discussed around pregnancy, the elderly, children, and drug interactions. Risk factors for suicide are also outlined.
This document discusses hormonal imbalances in women and their effects. It notes that depression is more prevalent in females, especially during fertile periods, highlighting the relationship between hormones and mental health. Common hormonal imbalances like PCOS and perimenopause can cause physical and psychological symptoms. Imbalances are linked to issues like brain fog, sleep problems, mental health risks, and certain health conditions. The document outlines treatments including medication, lifestyle changes, and natural remedies to help restore balance.
This document provides information about migraine in women. Some key points:
- Migraine is 3 times more common in women than men. Hormonally-associated migraines affect 12 million women in the US.
- Migraines are often associated with changes in hormone levels, such as during menstruation, pregnancy, use of oral contraceptives, and menopause.
- Diagnosis of migraine involves evaluating symptoms such as headache duration/intensity, nausea, light/sound sensitivity, visual/sensory disturbances (aura).
- Treatment involves both acute symptomatic relief and preventive medications, though choices are more limited during pregnancy/breastfeeding due to safety.
Depression (also called major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how we feel, think, and handle daily activities, such as sleeping, eating, or working.
Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years. Approximately 280 million people in the world have depression
Amenorrhea Presented By Muhammad Abdullah.pptxEmma269971
Amenorrhea is the absence of menstrual periods in women of reproductive age. It can be a sign of underlying health issues and can have significant impacts on a woman's fertility and overall health. In this PPT, you will learn about the definition, types, and causes of amenorrhea, including primary and secondary amenorrhea.
The presentation will cover the financial impact of amenorrhea on women's health, as well as the common symptoms and clinical findings associated with this condition. Additionally, the PPT will explore the differential diagnosis of amenorrhea, which involves ruling out other potential causes of menstrual irregularities, such as pregnancy, thyroid disorders, and polycystic ovary syndrome (PCOS).
The PPT will also delve into the treatment and management of amenorrhea, including lifestyle changes, hormone therapy, and surgical interventions. Furthermore, the presentation will discuss the crucial role of pharmacies in providing support and advice to women with amenorrhea, such as providing access to medications and monitoring treatment efficacy.
Overall, this PPT will provide a comprehensive overview of amenorrhea, from its definition and symptoms to its diagnosis, treatment, and management, highlighting the critical role of healthcare professionals, including pharmacists, in helping women with this condition.
Menopause is defined as the absence of menstrual periods for 12 months and marks the end of a woman's reproductive years. It is caused by a natural decline in ovarian function with age. The average age of menopause is 51 but it can occur earlier or later. Perimenopause is the transition period before menopause where estrogen levels fluctuate. Hormone replacement therapy can be used to treat menopause symptoms but requires evaluation for safety.
Sometimes two people can view the same thing in completely different ways. This presentation will illustrate some of the ways that patients and their providers commonly view the same thing in very different ways by sharing views of patients and doctors in a variety of common scenarios.
This document discusses opioid medication, addiction, and pain management. It defines key terms like addiction, tolerance, dependence, and withdrawal. It states that most chronic pain patients prescribed opioids do not become addicted, with estimates of addiction risk ranging from 3-20%. While some with addiction histories can safely use opioids, close monitoring is needed. Providers aim to prevent addiction through screening, treatment agreements, and education on safe usage and non-medication pain management.
How to set realistic goals when you have chronic painJeannette Pforr
In this lesson, you will:
- Understand the trade-offs between getting good pain relief, and being able to reach your activity goals
- Learn the value of having a "pain action plan"
- Learn how to set up your own action plan
- Learn how to track your action plan
In this lesson, you’ll learn:
- How to handle everyday activities while being kind to your back.
- How small changes in chore-handling can make a big difference in your daily life.
This lesson will help you understand:
- Whether or not it’s important for you to keep working
- Whether your current job is right for you
- If changes can be made to your job and workplace to let you keep working
- If you should move to another job
In this lesson, you’ll:
- Learn about your own support needs: Decide when you need support, how much is needed, and from whom.
- Learn how to find people and places for support.
- Understand the benefits and risks of online support.
This document provides guidelines for developing a safe exercise program for individuals with back pain. It recommends speaking with a healthcare provider before starting an exercise routine and progressing slowly. Light to moderate exercise can help prevent back stiffness and re-injury while strengthening the back muscles. The key to sticking with an exercise plan is to set small, realistic goals and find a buddy for added motivation and accountability. Safety is important, so see a doctor immediately if new or severe symptoms arise.
This lesson focuses on dealing with these kinds of disappointments. You will:
- Understand how negative thinking often goes hand-in-hand with poor health
- Learn how your thoughts can affect you mood AND your physical health
- Learn to think differently about the things that have happened to you
People with chronic pain often suffer from depression. In this lesson, you will:
- Understand how depression can happen with any chronic medical condition
- Learn how your mood can have an effect on physical symptoms
- Learn some ways to break the cycle of depression and pain
Pregnancy and caring for infants can strain a mother's back, but following proper lifting and positioning techniques can help reduce back pain. The document provides tips for safely lifting, bathing, feeding, carrying, and playing with babies and toddlers while protecting one's back through proper form and using back-supporting equipment when possible. It emphasizes pacing oneself, asking for help from others, and consulting a healthcare provider if back pain increases.
Complementary and alternative medicine (CAM) refers to medical practices that are not part of conventional Western medicine. CAM practices can be used together with or instead of conventional treatments. CAM includes manipulative practices like chiropractic and massage therapy that involve manipulating the body; biologically based practices using herbs, vitamins, and supplements; mind-body practices like meditation, yoga, and hypnosis; and energy medicine practices like acupuncture. Research suggests some CAM practices can help treat pain, but their effectiveness depends on the individual and condition. It is important to talk to a health care provider before starting any CAM treatment.
Most people with back or neck pain go to their primary care doctors as a first step in finding treatment. But many other health care providers are often involved in the treatment of back pain.
Although you are not likely to meet all of them, this tool introduces you to what they do, the treatments they provide, and the places they work.
This document provides information on herbal therapies for pain, including possible uses, typical doses and routes of administration, studies on effectiveness and safety, and potential adverse reactions. It profiles several herbal therapies, including arnica, black cohosh, camphor, capsaicin, chamomile, and cinnamon, outlining their traditional uses in treating pain and inflammation.
This document discusses several drug-drug interactions related to opioids. It explains that pure opioid agonists like morphine stimulate mu and kappa receptors, causing analgesia but also adverse effects. Pure antagonists like naloxone block agonists from binding to receptors. Mixed agonist/antagonists can cause withdrawal when added to a patient receiving a pure agonist. It also notes several additive effects from concurrent use of opioids and other drugs that decrease blood pressure, respiration, or cause nausea/vomiting. Special consideration is needed for elderly patients or those with reduced renal function.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
2. What is a migraine?
A migraine is a moderate to severe steady or throbbing
headache often on one side of the head that is commonly
associated with sensitivity to light and sound, nausea and
occasionally vomiting. It is a debilitating headache, usually
made worse by routine activity. A small number of people
may experience visual disturbances, called aura, just prior
to their headache. Diagnosis is typically based on clinical
evidence, including patient history and diary information.
3. What is a menstrual migraine?
People who experience migraines are called migraineurs…
(MM) includes menstrually related migraine (MRM) which
is a migraine headache that occurs regularly two days
before to three days after the onset of menstrual flow, as
well as pure menstrual migraine (PMM), which refers to
attacks occurring only during menstruation.1
1. MacGregor EA. “Menstural” migraine: Towards a definition. Cephalalgia 1996; 16:11-16.
4. How do hormones trigger a migraine?
Most female migraineurs report an increased frequency of
migraine attacks immediately before and during
menstruation. Understanding the hormonal fluctuations
that occur during the monthly menstrual cycle can be very
helpful in managing and preventing hormonally related
migraines.
5. How do hormones trigger a migraine?
The monthly menstrual cycle is regulated by hormones of
the pituitary gland and the ovaries, primarily estrogen and
progesterone. Menstrual migraine can be triggered by a
drop in serum estrogen levels, which has an effect on the
central nervous system, specifically the serotonin
receptors in the brain. When serum estrogen
concentrations decline, serotonin levels also fall. This may
provoke dilatation of blood vessels and activation of the
trigeminal nerve pathways, culminating in a migraine
attack.
6. The menstrual cycle and the migraineur
An average menstrual cycle is 28 days long, but can vary
widely from woman to woman. The menstrual cycle has
two phases: The follicular phase and the luteal phase.
Fluctuations in hormone levels, primarily in the luteal
phase, may trigger menstrual related migraines in
migraineurs.
7. The bar graph above depicts each phase of the menstrual cycle.
8. Follicular phase: The follicular phase is the first half of the menstrual cycle and gets its name from the
development of the new egg follicle in the ovary. “Day 1” of menstruation is marked by bleeding which is
caused by shedding of the endometrium. As the cycle begins serum estradiol and progesterone concentrations
are low, which cause the hypothalamus in the brain to increase gonadotropin-releasing hormone (GnRH). This
signals the pituitary gland in the brain to release the follicle-stimulating hormone (FSH) and luteinizing hormone
(LH). FSH and LH are carried to the ovaries. One dominant follicle will develop.
During this phase it is possible for a woman to experience a MM based on the drop in estrogen which occurred
during the second half of the last cycle preceding menstruation. This period of vulnerability may last several
days after the onset of menstruation, after which it is rare for a hormonally related migraine to occur. A
headache which occurs during the second half of the follicular phase is less likely due to hormonal triggers.
9. Ovulation phase: Mid-cycle, high levels of estrogen cause the pituitary gland to release a large amount of LH
(called the LH surge), which triggers ovulation. The dominant egg follicle bursts and releases the mature egg,
which travels to the fallopian tubes. This triggers a gradual increase in serum progesterone concentrations. A
small percentage of women experience migraine during this time.
10. Luteal phase: After ovulation the ruptured follicle becomes the corpus luteum, a mass of cells that produces
the hormone progesterone. If the egg is not fertilized, the corpus luteum deteriorates and progesterone
production halts. This causes the lining of the uterus to break down and once again triggers the onset of
menstruation.
A woman who is sensitive to hormonal fluctuations is most likely to experience a migraine during this phase
due to the drop in estrogen levels which, in turn, causes changes in the serotonergic system in the brain.
11. Intervention overview
The treatment approach for MM is the same as for
migraine occurring at any time. The primary goals of
treatment are to decrease attack frequency, duration,
accompanying symptoms, and disability. It is far preferable
to prevent a migraine attack than to treat one once it has
started, an all migraineurs should initiate preventive
healthy lifestyle strategies either alone or in addition to
pharmacological therapies.
12. Intervention overview
Patients may be advised to keep a headache diary for two to three
months to identify personal triggers such as hormonal, dietary,
weather, stress, and other issues. This will help physicians in
personalizing a treatment program to manage migraine.
Acute treatment approaches are employed first. For migraineurs who
do not obtain satisfactory relief with acute strategies and who regularly
experience MM, physicians may initiate preventive strategies. Many
health care providers will follow a stratified approach including
behavioral strategies, acute pharmacological treatments and if
necessary, non-hormonal or hormonal preventive treatments.
13. Non-Pharmacological Treatment:
Healthy Lifestyle Modification
All women who experience migraines should adopt a
healthy lifestyle and learn to avoid potential migraine
triggers. These habits can make a significant difference in
avoiding migraine attacks and reducing or managing pain
during attacks. These strategies should be combined with
any additional pharmacological treatments.
14. Non-Pharmacological Treatment:
Healthy Lifestyle Modification
These strategies include…
•Proper sleep and hygiene. Get regular and adequate
amounts of sleep (aim for eight hours for an adult and adjust
as necessary). Attempt to go to sleep and wake at the same
times every day including weekends and holidays. Avoid use
of sleep medication.
•Avoid Dietary Triggers, especially alcohol and caffeine.
Patients may keep a headache diary to identify other specific
triggers, although experts warn against excessive elimination
of foods. Eat regular, healthy meals and avoid skipping
meals.
15. Non-Pharmacological Treatment:
Healthy Lifestyle Modification
• Regular Aerobic Exercise or Walking. Establish an exercise
routine for at least 30 minutes, five days per week.
• Avoid Stress. Use relaxation and coping strategies, such as
relaxation audio tapes and exercises, yoga, tai chi, and/or
learning relaxation and biofeedback skills from a qualified
psychologist or mental health professional.
• Do not smoke.
• Avoid Rebound Headaches. Do not use acute medications
(such as anti-inflammatory medications, acetaminophen, or
opioids) more than twice per week or more than 24 acute
medications per month to avoid triggering “rebound headaches”
and other stressful effects on the body.
16. Acute treatment
Acute treatment of MM is similar to therapies for migraine occurring at
any time. Medications that have been proven effective or that are
commonly used for the acute treatment are described below. Patients
often self-medicate on their own with the over-the-counter
medications; however, this may not be effective. Either a non-steroidal
anti-inflammatory drug (NSAID) alone, or in combination with a rapid-
onset triptan medication, is often prescribed first. Many patients
eventually require a triptan. If severe attacks cannot be controlled with
these medications then other analgesics, corticosteroids, and
dihydroergotamine (DHE) may be considered. If acute management is
inadequate, prevention therapy is indicated.
17. Acute treatment
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are
medications which may reduce the severity, and duration of
migraine attacks and may also be useful to manage other
bothersome premenstrual symptoms. They work by
interfering in the formation of prostaglandins, which play a
role in migraine as well as other types of pain such as
dysmenorrhea. NSAIDs should not be used on a daily basis
or for extended periods of time without medical supervision
as there is a risk of developing a daily “drug rebound”
headache (i.e., a headache that returns as each dose
wears off) and potential gastrointestinal side effects.
18. Acute treatment
• Triptan medications are serotonin agonists. They can
eliminate or reduce pain associated with migraine as well
as reducing her migraine symptoms including nausea
and sensitivity to light and sound. Early intervention
(within the first half hour of migraine onset) is
recommended for maximum efficacy. Patients should
take the medication at the onset of pain, even if the pain
is only mild at that time. Use of triptans requires ongoing
medical supervision.
19. Preventive: Non-Hormonal Therapy
Preventive, or prophylactic, medications are prescribed to prevent or
reduce the number of attacks for migraineurs who experience frequent
migraines (2-3 or more per month.) A list of the classes of medications
used in migraine prevention is presented below. These therapies
require medical supervision. Each class of medications works
differently and may have other adverse affects or benefits. Preventive
medications typically take several weeks to reach maximum efficacy
and are dosed on a daily or cyclical basis. Successful therapy is
considered to be a 50% reduction in the frequency, duration, and
intensity of attacks. The majority of these medications are not FDA
approved as migraine prophylactic agents.
20. Standard Prophylactic Agents
• Anti-Epileptic Medications were originally used for the treatment of
epilepsy but have been shown to be effective in reducing the frequency and
severity of migraine attacks. Two medications, valproic acid and topiramate,
are FDA approved as migraine prevention agents.
• Calcium Channel Blockers and Beta Blockers are commonly prescribed
prophylactic agents for migraine. Traditionally used for management of high
blood pressure and coronary heart disease, these medications may relax
blood vessels and increase the supply of blood and oxygen to the heart
while reducing its stress. The improvement in blood flow may help prevent
migraine attacks.
• Antidepressants originally developed to treat depression are often
prescribed with a good degree of success in reducing both frequency and
severity of migraine, perhaps by regulating serotonin and adrenaline levels
in the brain.
21. Mini-Prophylactic Agents
• NSAIDs are often used on a daily basis to prevent the
onset of MM. They are typically initiated 2 days before
the expected onset of the MM and continued for 5-7
days.
• Long acting triptans, such as naratriptan and
frovatriptan, are increasingly being used for prophylaxis
of MM. Therapy begins two days before the anticipated
onset of the MM and is continued on a twice-daily basis
for 5-6 days.
22. Preventive: Hormonal Therapy
Hormonal prophylaxis may be appropriate and effective for
migraineurs
1.In whom MM does not respond to acute or non-hormonal preventive
approaches
2.Who are interested in contraception, or
3.Who may benefit from other effects of hormonal therapies (i.e.
women with endometriosis, menorrhagia, dysmenorrhea, and irregular
cycles.)
Since MM is precipitated by a decline in serum estrogen levels,
hormonal preventive therapies aim to reduce or eliminate this decline.
This may involve the use of a supplemental estrogen taken
perimenstrually either by mouth or in a transdermal patch.
23. Preventive: Hormonal Therapy
Another approach is for women to use an extended or continuous
regimen of oral contraceptives (OC). This can be achieved by (a) not
taking the placebo pills provided in traditional 21-day regimens,
although women will need to get extra packs in the course of a year, or
(b) with the newer FDA approved, extended 84-day oral contraceptive
formula. The best OCs in migraineurs are felt to be the low-dose,
monophasic formulations, as opposed to the bi- or tri-phasic pills,
especially those above 20mcg.
All of these strategies require medical supervision. For adolescent girls
with MM, a medical professional who is experienced in treating this
young population should be involved in the treatment planning.