Treatment of Migraine with Aura in Menstrually Associated Migraine
When migraine with aura follows a consistent menstrual pattern, the predictable timing of attacks opens the door to a targeted short-term preventive strategy distinct from standard continuous migraine prophylaxis.
Clinical scenario: Menstrually associated migraine with aura — attacks occurring from 2 days before up to 3 days after the onset of menstrual bleeding in at least 2 out of 3 cycles. The cyclical regularity of this pattern is both its defining feature and the basis for a specific preventive approach.
Treatment approach: Short-term prevention, started ahead of the expected attack window, is the cornerstone of management in this setting. The approach involves agents selected for their suitability to cover the at-risk perimenstrual period — the specific options, clinical selection criteria, and sequencing are detailed in the full protocol.
References
DOI: 10.1177/2514183X1882337
- By definition, menstrually associated migraine is a migraine in which the attacks occur exclusively in the time from 2 days before up to 3 days after the onset of bleeding in at least 2 or 3 cycles.
- When menstruation is normal, options for short-term prevention include the administration of naproxen or a triptan with longer half-life, starting 2 days prior to the expected start of migraine for a total of 6 to 7 days.
View source ↗