Menstrual migraine: a modern view on the problem
Azimova Yu.E. 

University Headache Clinic, Moscow

The review highlights the problem of menstrual migraines, one of the heaviest forms of cephalgia. A clinical picture of menstrual migraine is described. Attacks of menstrual and menstrual-associated migraines are more intense, more prolonged, more often accompanied by nausea and vomiting, more deconditioning for the patients and resistant to treatment. The data of fundamental researches carried out in recent years, which allowed to understand in many respects the pathophysiology of menstrual migraines, are given. Sex hormones (estrogen, progesterone, testosterone) significantly affect the function of the brain. Estrogens can modulate neuronal activity through estrogen receptors, widely represented in the central nervous system. The results of foreign studies on the treatment and prevention of menstrual migraine are highlighted. Treatment of menstrual migraines involves prevention and relief of the migraine attacks. Patients with menstrual migraine face a problem of insufficient competence of gynecologists regarding migraine and insufficient competence of neurologists regarding hormonal therapy. It is shown, that complex management of patients by neurologists and gynecologists improves the quality of the treatment and is considered a «gold standard». Since migraine attacks are much more difficult to treat, it is recommended to start with triptans therapy. Triptans can also be used for short-term prevention. Currently, it can be recommended for the patients with menstrual migraine to use the drug Migrepam (zolmitriptan).

Key words: menstrual migraine, zolmitriptan, Migrepam, estradiol, progesterone, headache.
For citation: Azimova Yu.E. Menstrual migraine: a modern view on the problem // RMJ. 2017. № 21. P. 1586–1590.