Menstruelle Migräne

Zusammenfassung

Die menstruelle Migräne ist seit Jahrhunderten als eine besondere Form der Migräne bekannt. Sie wird definiert als eine Migräne ohne Aura, deren Attacken in mindestens zwei von drei Zyklen in den Tagen um die Menstruation auftreten. Pathophysiologisch spielen neben hormonellen Faktoren wahrscheinlich auch inflammatorische, genetische und psychosomatische Mechanismen eine Rolle. Die menstruelle Migräne ist schwerer zu behandeln als andere Formen der Migräne. In der Therapie folgt die akute Attackenkupierung den Empfehlungen für Migräneattacken im Allgemeinen. Eine Besonderheit stellt die Kurzzeitprophylaxe dar, bei der in den Tagen vor der Menstruation täglich entweder Naproxen oder ein Triptan gegeben werden sollte. Möglich ist eine Hormontherapie entweder mit einem Östrogenpräparat in den Tagen vor der Menstruation oder mit einer kontinuierlichen Hormonbehandlung über den gesamten Zyklus.

Summary

Menstrual migraine has been known as a specific subtype of migraine for centuries. Menstrual migraine is defined as a migraine without aura with attacks occurring around the menstruation in at least two out of three cycles. Beside hormonal factors, inflammatory, genetic and psychosomatic factors probably play a role in the pathophysiology. Menstrual migraine is more difficult to treat than other subtypes of migraine. The acute treatment of attacks is not different from the treatment of other migraine attacks. A specific treatment is short-term prophylaxis in the days before menstruation either with daily naproxen or a daily triptan. Another possibility is a continuous treatment with hormones over the whole menstrual cycle.

Schlüsselwörter

Migräne - Menstruation - Triptane - Hormonbehandlung - Kurzzeitprophylaxe

Keywords

Migraine - menstruation - triptans - hormone treatment - short-term prophylaxis

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