Another virtually uncontrollable trigger is menstruation. The vast majority of migraineurs are women and approximately 60 percent of them report menstrual-related migraines. Add in the fact that migraine attacks occur most frequently between the ages of 15 and 55, a woman's most fertile years, and that makes Migraine Disease not only a women's health issue, but a mother's health issue.
Dr. Patrick Lavin, MB, BCh, BAO, MRCPI, Professor of Neurology and Ophthalmology and the Director of the Headache Clinic at Vanderbilt University, explains, "The fall in estrogen just before a period can precipitate a migraine. There is also a drop in estrogen mid-cycle, just before ovulation," that can also bring on an attack. Lavin says, "Female patients often find relief during pregnancy when hormone levels are steady and high."
Some women prevent migraines by taking low-dose birth control pills for several months at a time to avoid having more than four periods a year, but that method doesn't work for everyone. If a person experiences migraines with auras (tingling, strange smells, or odd changes in vision), it puts them at an increased risk for potentially deadly strokes. Since oral contraceptives also increase stroke risk, they might not be the right migraine preventative measure.
A small percentage of women undergo drastic procedures such as endometrial ablation, removing the uterine lining that causes monthly bleeding, or complete hysterectomies to remove the uterus and ovaries in an attempt to escape the crippling pain of migraines. Dr. Lavin recommends that anyone who suspects she is suffering from this disease should meet with a headache specialist to determine her best course of prevention and treatment.