Chronic migraines tend to improve after menopause due to changes in female hormones. Migraines are more common among adult females and may be triggered by either their menstrual cycle or pregnancy.
Keep a headache diary to identify triggers can help manage headaches more effectively, while certain medications, including tricyclic antidepressants, beta-blockers and calcium channel blockers may also provide some relief.
Over-the-Counter Pain Relievers
Most individuals suffering from migraine use over-the-counter treatments that are accessible and more cost-effective than prescription medicines; such as acetaminophen or ibuprofen as first-line therapies for chronic migraine patients.
These medications work by relieving inflammation that causes pain. But excessive use can lead to stomach ulcers or bleeding that worsen your symptoms further.
Prescription treatments go beyond OTC drugs to include preventive and rescue medicines that reduce headache frequency and severity, while also being FDA-approved to stop migraine attacks once they start. Recently, multiple new drugs for treating chronic migraine were approved.
Triptans
Triptans, or triptan medications, function like brain chemicals to relax overactive nerve endings during migraine attacks. Your GP will likely prescribe either an oral drug such as sumatriptan (Imitrex) or nasal spray treatments such as frovatriptan (Frova), naratriptan (Amerge), or zolmitriptan (Zomig). They’ll determine which option would work best with your symptoms and length of headache episodes.
These medications work best if taken as soon as an attack begins. Unfortunately, those with heart conditions should avoid them as they narrow blood vessels. Furthermore, taking too often could result in medication-induced headaches, which is why your GP may refer you to a headache specialist.
Gepants
Gepants are small molecules that prevent CGRP from binding to its receptors and prevent migraine attacks. There are four gepants currently available: rimegepant (Nurtec), ubrogepant, atogepant and zavegepant; these medications may be given via injection or infusion therapy, oral dissolvable tablets or nasal spray for acute treatment or prevention of episodic and chronic migraine.
Studies have demonstrated the efficacy of gepants to relieve migraine pain, light and sound sensitivity, and other associated symptoms. They have also been proven to decrease migraine recurrence rates. Access may differ depending on where you reside; check with your GP or primary healthcare provider regarding availability in your region.
Dark Rooms
Many individuals who suffer from migraines are particularly sensitive to light. Light sensitivity is one of the main triggers for migraine attacks and can worsen an ongoing attack, so dark rooms are an invaluable aid for people living with migraines. They allow patients to avoid lights that might trigger headaches, as well as avoid being exposed to things that worsen head pain and other symptoms. Homeopathic remedies that may provide assistance include Natrum Muriaticum for migraines, which have been described as “hammers beating the head.” Relieved by lying down and entering a dark room; worsened by movement, smells or bright lights; triggered by menstruation or grief – homeopathy offers hope!
Relaxation Techniques
Regular practice of various relaxation techniques has been demonstrated to reduce migraine attacks. These techniques include deep breathing exercises, progressive muscle relaxation and visualisation exercises.
These strategies have all been shown to alter the body’s stress response from fight-or-flight into rest-and-relax mode, which in turn reduces migraine attacks while soothing their severity during an attack.
Other preventive treatments for headaches may include following a consistent sleep schedule, eating at the same times daily and staying hydrated. Acupuncture and cognitive behavioral therapy have both shown to decrease migraine frequency and severity in some individuals.
Diet
Researchers have recently demonstrated the value of eating a nutritious, well-balanced diet as an aid to migraine prevention. A diet like MIND’s (Meditation, Inclusion of Neuroprotective Foods, and Avoidance of Things That Trigger Headaches) which features whole foods like green leafy vegetables, fruits, beans, nuts and seeds is associated with reduced frequency and severity of headaches.
Avoiding triggers such as caffeine, MSG and monosodium glutamate may help reduce headache frequency. However, strict elimination diets should only be undertaken under medical advice as strict diets may lead to nutritional deficiencies; thus they should not be the main strategy used for migraine management.
