By E. Anne MacGregor
Thoroughly up to date and revised, this version of Migraine in ladies explores the hyperlinks among migraine and hormonal alterations and the potent administration in quite a few levels of lifestyles. The ebook outlines the consequences of menstruation, being pregnant, birth control, the menopause and HRT on migraine, studies the mechanisms concerned, and gives functional suggestion on therapy. the writer defines the kinds of migraines, who will get them, and their scientific analysis. She discusses acute and prophylactic remedy and provides an outline for handling migraines. The ebook contains the overseas Headache Society diagnostic standards.
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Extra resources for Migraine in Women
If nothing works, review the diagnosis, considering the coexistence of other headache, particularly medication misuse. 6 Prophylactic treatment The clinical course of migraine is such that periods of exacerbation tend to resolve spontaneously without intervention. No prophylactic drug provides more than 50% improvement-as effective as identification and avoidance of trigger factors. ’). If prophylactic drugs are prescribed, their continued need should be assessed at each follow-up visit. Identify triggers If patients have frequent attacks of migraine, more than once a month, they may find keeping a trigger diary useful, in addition to the attack diary.
Given for HRT, it is important to note that for ‘menstrual’ migraine, hormones are given as supplements. Provided the woman is ovulating regularly, no additional progestogens are necessary. This is because she will be producing adequate amounts of her own natural progesterone to counter the effects of unopposed oestrogen, which could otherwise lead to endometrial proliferation and hyperplasia. e. day 21 of a 28-day cycle. The level should be greater than 30 nmol per litre. Side-effects due to excess oestrogen include breast tenderness, fluid retention, nausea, and leg cramps.
Typical side-effects include lethargy, vivid dreams, and cold extremities. Patients with asthma, brittle diabetes, chronic obstructive airways disease, myocardial insufficiency, and peripheral vascular disease should avoid beta-blockers. They should not be used concomitantly with ergotamine. Amitriptyline is particularly useful if there is associated depression, sleep disturbance, or tension-type headache. Higher doses are usually only necessary for associated depression. Most side-effects, including sedation, dry mouth, dizziness, and blurred vision, improve after the initial weeks of treatment.