Wednesday, May 29, 2013

12 Recommendations on How to Prevent and Ease Migraines at Menopause

What is migraine?

Migraine is an inherited, or acquired, combined disorder of the nerve and vascular tissue of the brain. The manifestation of this disorder is the headache, which occurs intermittently as a result of a stimulus or "trigger." In those affected, the frequency can vary markedly, and the headaches can occur rarely or on a daily basis. Common triggers include, odors, flashing lights, stress, lack of sleep and other various stimuli. Hormones can act as a trigger and a common variety of this is what is called "menstrual headache." This type of migraine is usually related to the fall in estrogen levels that occur prior to menstruation. It is also likely that progesterone sensitivity plays a role as well in many women.

Typically, migraines cause a moderate-to-severe throbbing pain that is worse on one side of the head, and is usually aggravated by physical activity. Other symptoms, such as nausea, vomiting, and sensitivity to light and noise, are common. Migraines usually last 4 to 72 hours and may occur rarely or up to several times a week.

There are two types of migraine headaches: those with aura and those without aura.

Migraine with aura. A woman may have some of the following sensory symptoms (the “aura”) before a migraine begins:
·         Seeing flashing lights and floating lines, or developing temporary peripheral blindness
·         Numbness or tingling in the face or hands
·         Distorted sense of smell, taste, or touch
·         Mental confusion

Migraine without aura. A woman will have all the other features of a migraine but will not have the sensory symptoms beforehand.

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Migraine and menstrual cycle

The common understanding is that migraine is primarily a disease of young, healthy women. Its onset often coincides with the initial period and is triggered by the monthly menses in over 60% of females. So, for women, whose migraine has been closely linked with their menstrual cycle, the elimination of that trigger with the onset of menopause can result in real improvement, although it is rare for attacks to disappear entirely. In contrast to physiologic menopause, surgical menopause results in worsening of migraine in two thirds of cases.

Getting older is also usually associated with both headaches and associated symptoms becoming less severe so it may not be only menopause, but also aging, which produces headache improvement in many cases.

Perimenopause is sometimes associated with worsening migraine as a result of hormone fluctuations. In addition, irregular menses can make management of the condition less predictable. As menopause progresses, the plasma levels of sex steroids decline and migraine frequently abates. Even so, in the general population between the ages of 55 and 60, the incidence of migraine in women is still higher than men. This suggests that some factors other than hormones contribute to the predominance of migraine in women, but the reasons for this are not well understood.

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Onset of menopause

From about the age of 40 onwards, you become less fertile as your ovaries gradually stop producing eggs each month. The time from when your periods become irregular until they stop is called the perimenopause. The menopause marks the time when your periods stop completely. This process can last as long as twenty years. The average age for the menopause is between 51 and 52 years with a range of 40 to 60 years.

You may find that your migraine attacks are linked to your periods during the perimenopause. The ovaries produce less estrogen and changes in your hormone levels can make your migraine attacks become more severe or happen more often.

In the few studies that have been conducted it is suggested that the menopause makes migraine worse for up to 45% of women, 30-45% do not notice a difference and 15% notice an improvement. Some women find their attacks continue to follow a cyclical pattern years after the menopause and the reason for this is unclear.

It is recognized that the hormonal cycle can continue for some years after the last menstrual period, although the hormone changes are not sufficient to result in menstruation but could still provoke migraine. In these cases, hormones as a trigger factor for migraine should settle within 2 to 5 years after the menopause.

However, cyclical migraine can occur for reasons other than the menstrual cycle – our bodies run on a whole system of different hormonal “clocks”, which could also play a role in migraine.

Other non-hormonal triggers may become more obvious after your menopause, as well as additional ones that develop such as neck tension.

These may provoke attacks in a cyclical pattern. This works on the pattern of an individual having a “threshold” to migraine and different factors building up over time to cross the threshold and trigger migraine.

The menopause can be a difficult time for women with migraine. The irregularity of your periods can make it harder to cope with your migraine as they may be more difficult to predict. Typically the problems that can be experienced at the menopause (hot flushes and night sweats) result in disturbed sleep, adding to your stress levels and therefore increasing the likelihood of you experiencing a migraine.

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How are migraines treated?

In this section, we will list several useful approaches and lifestyle changes to help you prevent and easy the migraine occurrences. They are quite personal from many perspectives, and some interpersonal investigation is required to find out the best individual recipes and approaches.

1.       Phytoestrogens

Phytoestrogens are plant compounds similar to estrogen. There are various ways to ingest these compounds such as through food sources which include soy or herbs such as black cohosh. Supplement products containing isoflavones, a component of soy, are widely available and can be purchased as capsules or shakes.

One study suggested that a combination of soy compounds, dong quai, and black cohosh was associated with a lower risk for migraines but other studies have found no link. In fact, some studies have found that phytoestrogens may even exacerbate migraines and as such, it can be very confusing for women to choose a migraine treatment during menopause.

Ultimately, women may best be advised to keep their hormone levels as steady as possible during menopause. The process of relieving migraine headaches during menopause is similar to general migraine treatment advice: find what works best for you. It may require trial and error to identify triggers and find a dose regimen with supplement with phytoestrogens, if at all, that works.

2.       Avoid strong scents

Many people find that strong scents, such as perfume or cleaning supplies, can trigger a migraine or make an existing migraine worse. Opt out of heavily scented fragrances and instead use fragrance-free products, even when it comes to your shampoo, deodorant, and body lotion. When using cleaning supplies, make sure to use “green” products, which tend to have a lighter scent, and open the windows or turn on a fan to keep the room ventilated.

3.       Lose the hair accessories and avoid chewing gum

Anything that puts excess pressure on your head (such as a tight headband or a restrictive ponytail holder) can exacerbate migraine symptoms. Use loose-fitting cloth hair-holders when necessary, and don’t make the style too tight or constrictive. Gum chewing also can be a migraine trigger, especially if you tend to bite down really hard as you chew. You can try mints instead.

4.       Lower cheese consumption

Cheese is a big migraine trigger because it contains tyramine (which has been associated with migraines). Instead of cheese, reach for a creamy snack like hummus or all-natural peanut butter. Wine has also been associated with migraines because of its tyramine content, so swap your glass of red for fresh lemonade or a glass of ice water.

5.       Be careful with coffee

A cup or two of coffee isn’t necessarily a bad thing when it comes to headaches. In fact, a little dose of caffeine can actually be beneficial in treating headaches. However, too much caffeine can trigger a migraine, so it’s best to limit yourself to a small serving of caffeine each day.

6.       Exercise in moderation

Excessive exercise can have the same impact as excessive caffeine when it comes to triggering migraines. However, as with caffeine, moderate exercise can help to prevent migraines. Exercise gets the blood flowing and keeps the muscles strong and fit. Choose moderate exercise activities like walking, yoga, or Pilates.

7.       Manage properly your blood pressure

The high blood pressure may cause migraine headaches. These headaches are brought on when the blood flows fast through the blood vessels in the head. As the blood flows fast the blood vessels enlarge. As the vessels enlarge pain occurs.

Monitor your blood pressure and regulate with medications or natural products as needed. Eat plenty of fruits and vegetables. Instead of frying meat and fish, bake or broil it. Fried foods can increase the blood pressure. Avoid adding large amounts of salt and sugar to freshly cooked dishes. Whenever you get hit with the sweet tooth eat fresh fruits and drink fruit juices that are made with one hundred percent fruit juice.

8.       Health diet and plenty of water

Finally, make sure to eat regularly throughout the day and don’t skip meals. Healthy, whole foods and plenty of hydration (and sleep!) are key to a life without migraines.

Keep a diary to locate the food, which might trigger your migraines. The most common foods causing migraines and headaches are:
·         Any processed, fermented, pickled, or marinated foods, as well as foods that contain monosodium glutamate (MSG)
·         Baked goods, chocolate, nuts, peanut butter, and dairy products
·         Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
·         Fruits (avocado, banana, citrus fruit)
·         Meats containing nitrates (bacon, hot dogs, salami, cured meats)
·         Onions.

9.       Magnesium intake

One proven cause of headaches and migraine headaches can be a magnesium deficiency. Magnesium is responsible for hundreds of different functions in the human body, so a deficiency of this one important mineral can lead to a wide range of seemingly unrelated maladies. Other conditions often linked to magnesium deficiency may include anxiety, depression, migraines, nystagmus (shaky eyes), asthma, heart palpitations, temporomandibular joint disorder (TMJ), muscles cramps, mitral valve prolapse, rickets (sunken or barrel chests, scoliosis, bow legs, etc.), hypersensitive hearing and chemical sensitivity.

Migraines are often treated with medications containing magnesium sulphate, but yet most doctors fail to ask patients about magnesium intake in their daily diets. Studies show that most people in the U.S. and other industrialized countries often do not consume the recommended daily amounts of magnesium, so eating a diet high in magnesium rich foods would be a simple, inexpensive and logical treatment for many migraine sufferers to try.

10.   Medications

Some medications can prevent migraines from occurring (magnesium, aspirin, triptans, ergots, and hormone therapy) or stop a migraine that has already begun (triptans and nonsteroidal anti-inflammatory drugs).

To prevent migraines, you may wish to try the following over-the-counter products: co-enzyme Q10 (CoQ10) 150-300 mg per day; vitamin B2 (riboflavin) 400 mg per day; and/or magnesium supplements, 200-800 mg per day. Each may take up to three months to become effective, where “effective” means at least a 50 percent reduction in migraine frequency. Magnesium may cause abdominal cramps, diarrhea and nausea, so it’s best to start at a low dose and increase it weekly by 100-200 mg as tolerated until you see some benefit. You would still take rescue medication, such as Excedrin and Imitrex, for breakthrough pain.

11.   Stress reduction

Although a definite reason why stress may trigger migraine is not clear, researchers have discovered strong correlation between stress and migraines in many cases. One theory is that stress leads to the release of protein particles called peptides that makes blood vessels expand and become inflamed. This begins a series of events which cause nerve cells to become over-stimulated leading to the pain and other symptoms of a migraine. Researchers have also found altered levels of stress hormones in migraine sufferers, which may be responsible for triggering migraines.

There are multiple approaches to address stress related migraines, and among them:
·         Getting adequate sleep
·         Learning stress-reducing techniques such as yoga or relaxation techniques such as biofeedback
·         Using progressive muscle relaxation
·         Cognitive behavioral therapy, to help patients recognize and deal with things that cause them stress, examine their thoughts and modify those that might contribute to stress or other issues such as depression or anxiety
·         Biofeedback, a mind-body technique, has been found particularly useful for migraine relief.

12.   Acupuncture

Acupuncture has been found very helpful for migraines relief and prevention. A new study 2012 of acupuncture — the most rigorous and detailed analysis of the treatment to date — found that it can indeed ease migraines and arthritis and other forms of chronic pain. The findings provide strong scientific support for an age-old therapy used by an estimated three million Americans each year.

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