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Menstrual migraines - unable to take anti-inflammatories

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Posted 11/11/2007 1:57 PM (GMT 0)
I was reading the post about menstrual migraines but I didn't see what I need help in.  I recently had an endometrial ablation done to help relieve me of my monthly cramps (which were horrendous!) and to help keep my Ulcerative Colitis flares at bay (which was mainly hormone related).  I just recently had the ablation done, so I'm not sure if this will stop my monthlys or not but I still get the hormonal swings (much much milder though) and with these hormonal swings I get severe headaches/migraines.  Always have.  My headaches have downgraded from migraines to bad headaches - it sort of feels like someone has my head in a vice instead of a car driving over my head now!  But I am unable to take the usual things to help relieve headaches because of my UC.  Any anti-inflammatories or NSAID's in people with inflammatory bowel diseases can cause intestinal bleeding.  So I am stuck with Tylonel.  Is there anything else I can do to help relieve this pain?  Tylonel only keeps it down to a dull roar.  Is there any medication on the market that is in the same class as Tylonel that is not a narcotic?  I hate narcotic pain relievers because once again, it affects my UC.  I guess I'm stuck in between a rock and a hard place with these stinkin' headaches and I am so fed up with them!

Any suggestions??  confused

Posted 11/11/2007 5:37 PM (GMT 0)
Hi Red,

Sorry to hear that you are in this predicament with your meds and gut problems. I agree with you over the narcotic meds as they do more harm than good in the long run and that is without any gut problems!!!!

Has your Doc tried any of the triptans with you for your headaches? For instance Maxalt?? The triptans are not pain killers as such although their result is to kill the pain, they act in a very different way - on your blood vessels that cause the pain in the first place.

The triptans are mainly prescribed for Migraine and Cluster Headache, but they can have a positive effect on other headaches!!! Please talk to you Doc about these!!!

take care

Ann
Posted 11/11/2007 6:32 PM (GMT 0)
Thanks Ann :) I haven't talked to my doctor about these headaches yet because truthfully I wasn't even sure she would be able to do anything for me. I get tired of docs throwing their hands up in frustration because of what I can and can't take that I guess I'm a little gun shy when it comes to doctors. But thank you for offering your advice! The next time I go in to see my primary I will bring this up now that I know that something can be done about it. The triptan meds, do you take them all the time or only when you have the headaches? Because my menstrual headaches usually only last the week before I'm due to start and then I'm fine for the rest of the month but it can be a loooooonggg week!
Posted 11/11/2007 8:32 PM (GMT 0)
Hi Red,

The triptans (Maxalt, Zolmitriptan, Sumatriptan etc) are used as an abortive to stop the attack! They can only be taken twice in any 24hr period and you must not mix them - i.e. one Sumatriptan tablet and a Maxalt in that 24 hrs!!!

There may be something else your Doc can suggest, but as you say with IBD you have to be careful.

I have just read in your signature that you have Reynauds Syndrome - sorry I should have seen this before, as the triptans are contraindicated with Reynauds because of the effect they have on the blood vessels! But as it is secondary your Doc may still prescribe a triptan!!! As always please discuss this thoroughly with your Doc!

Hope you can find something soon, take care

Ann
Posted 11/12/2007 12:22 AM (GMT 0)
So triptans restrict blood flow? That wouldn't be too good for my Raynauds then since I take Norvasc as needed and that's a vasodilator. I guess I will ask the doc for suggestions. Is there anything natural out there that can help with these headaches?
Posted 11/12/2007 8:46 PM (GMT 0)
I take imitrex for my menstrual migraines, not sure how that would work with your other meds, I think it's in the same family as maxalt. But - I've had good luck with it. I can't take any aspirin of nsaids due to stomach issues.
Posted 11/12/2007 8:56 PM (GMT 0)
Of all the triptans, Frova is specifically designed to deal with migraines associated with menstruation. My mom takes it, she says it helps a lot. Give it a shot if you can.
Posted 11/14/2007 2:23 AM (GMT 0)
Thank you doghouse and korbnep :) I usually have these little things (extra intestinal manifestations from my Uc) that go wrong at the same time that I make a list for when I go to the doctors. So, your suggestions will go on "the list!" I will definately ask the doc about triptans about whether or not I can take them. Thanks again!
Posted 11/15/2007 8:37 PM (GMT 0)
My neuro put me on Cymbalta (an anitdepressant) for the menstrual migraines.  It seems to have worked a little, although I'm getting the migraines so frequently now that I think nothing is helping me anymore...

Posted 11/15/2007 10:10 PM (GMT 0)
Yeah, Cymbalta's kind of hit or miss with it's supposed anti-neuropathic pain capabilities.
Posted 11/16/2007 6:10 PM (GMT 0)
I was going to recommend Maxalt too but definitely check with your doctor. I love this drug b/c once I feel a headache coming, I take the pill and 10-20 minutes later......poof! it's gone.

I hope you'll be able to take this medicine.
Posted 11/24/2007 9:53 PM (GMT 0)
Red I have migraines also, anywhere from 3-4 a week and sometimes daily. I only take midrin which doesn't really help. I read your post and you mentioned you had the ablation, is everything going okay with that? I'm thinking of having the nova sure ablation. My periods are heavy and I deal with migraines everyday of that month. pain!

Wishing you the best,

Mercyme
Posted 11/30/2007 2:04 AM (GMT 0)
I went on a gluten-free & corn-free diet and my Menstrual Migraines went away. Have you been tested for gluten intolerance or any food allergies?
Posted Yesterday 12:48 PM (GMT 0)
Red,
Check your email, I've sent you a journal article written by the neurologist in charge of the Jeffereson Headache Center called "HORMONE-RELATED HEADACHE". I hope it helps!

Mercyme, Tikitana, and doghouse, I'd be happy to send a copy along to you as well, but your email addresses are not available. Please let me know if you're interested.

The abstract reads:

There is a link between the female sex hormones, estrogen and progesterone, and migraine. Migraine occurs more frequently in women than in men, although prevalence is equal in prepubertal children. Migraine develops most frequently in the second decade, with the peak incidence occurring at adolescence. Menstrually related migraine (MM) begins at menarche in 33% of affected women. MM occurs mainly at the time of menses in many migrainous women and exclusively with menses (true menstrual migraine [TMM]) in some. MM can be associated with other somatic complaints arising before and often persisting into menses, such as nausea, backache, breast tenderness, and cramps, and, similar to them, appears to be the result of falling sex hormone levels. Premenstrual migraine can be associated with late luteal phase dysphoric disorder (premenstrual dysphoric disorder, also called premenstrual syndrome [PMS]), which is distinct from the physical symptoms of the perimenstrual period and probably is not driven directly by declining progesterone levels. Migraine occurring during (rather than before) menstruation usually is not associated with PMS.

Migraine often worsens during the first trimester of pregnancy. Although many women become headache-free during the last two trimesters, 25% have no change in their migraine. MM typically improves with pregnancy. Hormonal replacement with estrogens can exacerbate migraine, and oral contraceptives (OCs) can change its character and frequency. Migraine prevalence decreases with advancing age but may regress or worsen at the menopause. Changes in the headache pattern with OC use and during menarche, menstruation, pregnancy, and menopause are related to changes in estrogen levels. These phenomena suggest a relationship between migraine headaches and changes in sex hormone levels. This article discusses the endocrinology of the menstrual cycle and approaches to the therapy of hormone-related headaches, in particular headaches associated with the menstrual cycle, the menopause, and OC use.


Regards,
Ben
Posted Yesterday 1:33 PM (GMT 0)
Mercyme, I'm sorry I didn't respond earlier! I just now saw that you had asked a question. It's obvious I don't come on the migraine forum frequently huh? :) I had the Novasure done and it was a breeze. They did it in office with heavy duty narcotics (which I later had an adverse reaction too that sent me to the ER!) but the actual procedure took less then 5 minutes. I haven't had a period since October and I may never have another one again. However, the ablation doesn't mess with the hormones (unfortunately) so I still get the hormone migraines, just not as severe it seems. So maybe, the ablation did help a bit with that?

Ben, thank you for the article. I haven't had a chance to read all of it but I plan on doing that later. :)
Posted Yesterday 6:05 PM (GMT 0)

Red_34 said...
So triptans restrict blood flow? That wouldn't be too good for my Raynauds then since I take Norvasc as needed and that's a vasodilator. I guess I will ask the doc for suggestions.

Hello again Sherry,
I'm not sure if you ever got a proper response to your question here so I'll give it a shot. I'm fairly certain that taking triptans will not interfere with your Norvasc. I have three reasons for saying so :p 1)Norvasc is a Calcium channel blocker similar to Verapamil and I take Verapamil and am allowed to take triptans (also, Calcium channel blockers are fairly common medications for migraines so they shouldn't interfere with triptans, an even more popular class of migraine medications). 2) Drugs.com and RxList.com do not list triptans as drugs that cause adverse reactions with Norvasc. 3)"[Norvasc] inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle...with a greater effect on vascular smooth muscle cells than on cardiac muscle cells." Norvasc is a peripheral vasodilator. It differs from centrally acting vasodilators in that it does not cross the blood-brain barrier (due to it's high molecular weight, I believe, >500). Triptans act on cranial arteries in the brain, so the two should not interfere with each other.

Anyhow, 1 and 2 make a pretty good case that Norvasc and triptans are not contra-indicated. However, I'm not 100% sure about #3, so I would still as your doctor, though I believe that I am right.

Good luck,
Ben
Posted Today 2:39 AM (GMT 0)
Thank you Ben for the information. I take such a low dose of Norvasc (2.5mg) and only as needed so even if I was to take a triptan (if I EVEN can), I doubt too now that they would interfer with each other. I haven't been in to the doctor yet for this yet since I'm not at the "time" and I'm sort of curious as to what the month will bring. This will be my first whole month of no symptoms from the ablation - so I want to see how my monthly is going to affect the "new" me :) Oh and I found out too that my doctor has just moved to a new location so I have to go sign a records release form and try to figure out where she went (yeah, I'm going to ask the receptionist when I go sign the release).
Posted 12/4/2007 7:22 AM (GMT 0)

Red, I had two thoughts after reading your posts about migraines. I suffered from migraines from puberty until my early 40's when they worsened to the point of ridiculous but at the time I did not know they were migraines.  I thought they were sinus and tension headaches so I was eating tylenol, aspirin and sinus medications like they were M&M's.  I had other symptoms that I mentioned to the doctor like blind spots, auras, vertigo but was basically ignored until I had a retinal artery stroke and then 3 months later, a second one. The neurologist said I was one of the small percentage of people that migraines caused that to happen.  It is rare but it does happen. After that I was put on aspirin, midrin and daily Topamax for the migraines. Did it help? Sorta.They weren't as often but I was so tired of them. So tired. Anyway, my first thought was that whenever anyone tells me they are having migraines, I always ask if they are having other symptoms and if so, please tell the other symptoms to a doctor and make sure the doctors Hears what you are saying.

My other thought was that around the same time the migraines increased, I was also suffering from terrible pain, increased blood loss, increased duration and clots during my period and then I started getting ovarian cysts. The Merck Manual says "As menopause approaches (when estrogen levels are fluctuating), migraines become particularly difficult to control."  Anyway, after having a hysterectomy with one ovary removed (final diagnosis - Adenomyosis), the migraines decreased by about 80%.  One and a half years later, the migraines are still down by 80% and when I do have them, the midrin takes care of them right away.  I don't know how old you are but has your ob/gyn checked your estrogen levels?  Maybe there is some funny business going on with that and I believe that can happen to any woman at any age.

I don't know if this information helps you but my heart goes out to you.  And P.S., not to be a smarty pants but in the interest of getting the spelling right so people can look it up and see what a nasty little disease it can truly be - Reynaud's is actually spelled Raynaud's (named for Maurice Raynaud, the French physician who first described it) and it is also the second letter in the illness I have - CREST syndrome.

Hugz,

Alaina

Posted 12/4/2007 8:11 PM (GMT 0)
Thanks Alaina :) In regards to what you mentioned about the retinal artery stroke - no I don't have those symptoms. Just alot of pressure type pain but no visual disturbances nor vertigo. I've already had one ovarian cyst drained (it was 6cm-? is that the right measurement?? Sorry - I'm metrically challenged! lol), and I currently have 2 small ones that the doc is just watching. I do believe that I am entering an early menopause but the doc said that there is not a test they can do to check my hormone levels - is that true - I've heard contradictory stories everywhere about this? My migraines got really bad in my early 30's (I'm 37 - almost 38 now), but I had them basically since I started having my periods.

And thanks on the spelling tip! :)
Posted 12/6/2007 8:32 PM (GMT 0)

Red, to the best of my knowledge, there are tests for measuring hormone levels.  Webmd says that they can measure estradiol levels and measure FSH (follicle stimulating hornone) levels to check for early menopause.  There are a couple of websites that have good information about women issues: obgyn.net and hystersisters.com.  Both websites have tons of information about hormones, pre-menopause, etc.  Whenever I have questions about anything female, I usually check those websites first.  You are having migraines and ovarian cysts. 

Can you tell me what other things are going on? Before your ablation was there heavier bleeding, bloating, clots, anything like that? And what has your ob/gyn said about the cysts? Also, tell me about the headaches again - how often the headaches are, are they one-sided and how long they last, do you have light and/or sound sensitivity or nausea, anything else you have noticed?  And also, has anyone ever tried a Toradol shot on you when you have had a migraine? It is an NSAID but it is an injection in your hip or arm so it is bypassing the stomach. Or has anyone tried the compazine/benadryl combination on you? The emergency rooms seem to be going to this combo a lot although I am not convinced it works any better than midrin or excedrin migraine or just plain ole ibuprofen (which I know you can't take) and compazine makes me feel like I'm crawling out of my skin.

I'm asking because it sounds like you are not getting good info from your ob/gyn and I am still wondering if your migraines are hormone related (which it sounds to me like they are) and whether or not all of your symptoms are related to some kind of female issue like endometriosis or adenomyosis. I think that doctors sometimes get tunnel vision about symptoms and may not see the whole picture. Do you have a family physician or internal medicine doctor? I really want to help you get to the bottom of these migraines so I'm asking questions to see which direction would be better to go -- pester the family doctor or pester the ob/gyn or find a neurologist to pester. There are ways to treat migraines and I think part of getting good treatment is knowing which doctor to ask. These days, you have to be your own patient advocate. 

Alaina 

Posted 12/10/2007 12:17 PM (GMT 0)
Alaina, the reason I had the ablation is not due to heavy bleeding but to help control the most incredible awful cramps! It literally felt like there was an alien in there trying to rip out (sorry to be so graphic!) but the pain was intense and also I would flare with my Ulcerative Colitis with my periods. It was a vicious cycle with my UC and periods and pain. I had a D&C, laproscopy and hystoscopy(?) before I had the ablation in which he checked me over pretty good and no I don't have endo. I tell you though that after the D&C when I had my period, it was heaven because I was pain free cramp wise and that is what pushed me to have the ablation. My cysts are a side effect of my UC. Uc has many extra intestinal manifestions and ovarian cysts are quite common in Ibd'ers. In fact, 80% of women who have IBD get ovarian cysts. Yes, I've tried Toradol. But only when I had the ablation. This is one of the main meds they gave me that threw my Uc into a major flare with a lot of intestinal bleeding. I am highly sensitive to any NSAID in any form. But it is not my stomach that is sensitive but my whole system.

The headaches would last an entire week before I start my periods, all day for about 5-7 days with pain all around my head, pressure type pain, sometimes light and sound sensitivity but no nausea. No, I have never tried the compazine/benedryl combo but truthfully that combo scares me! I'm highly afraid of any narcotic pain reliever - compazine is a narcotic pain reliever or no? I'm not quite sure what that is but I've heard of it before. lol But any sort of med I do take, can't make me groggy during the day because I the primary caregiver to my 88 year old grandmother who has mild dementia or alzheimers.
Posted 12/10/2007 1:42 PM (GMT 0)
Compazine is an antiemetic, it helps control nausea or vomiting. It's not even very strong as far as prescription antiemetics go, let alone near being narcotic strength. With so many drugs around though, it's easy to confuse them :)

Also, I've more often seen the Benedryl/antiemetic cocktail including DHE as well. DHE is really the centerpiece but is a vasoconstrictor as well.
Posted 12/10/2007 11:00 PM (GMT 0)
Thank you Korbnep for clarifying that for me. I knew I heard of that before! Just wasn't sure where :) I am going to the doctors tomorrow with various complaints (ohhhh she's gonna LOVE me!) and I plan on bringing this up.
Posted 12/11/2007 4:16 AM (GMT 0)
Frova does nothing for my menstral migraines. I get them everymonth and the have tried the Frova 6 time now and nothing. For those that it does help... Cograts! I wish it did for me.

Purplegdaisy
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