| Q: |
How can menstruation and menopause trigger attacks?
|
| A: |
During the last fortnight of the menstrual cycle, the level of
estrogen (a female hormone) gradually decreases. This withdrawal
directly affects brain cell function and can trigger a migraine attack.
During menopause, a woman’s body produces estrogen and progesterone (the
sex hormones responsible for reproduction) more erratically. The
disrupted estrogen can trigger migraine. Following menopause, estrogen
and progesterone levels are consistently low, hence migraine can
improve.
|
| Q: |
Why can missing a meal or eating too many carbohydrates cause an attack?
|
| A: |
Missing a meal can lead to hypoglycemia (low blood sugar). It is
thought that hypoglycemia triggers migraine by causing the release of
epinephrine and other hormones associated with the stress response.
These hormones lead to an increase in the blood sugar levels. The body
then releases insulin to bring these levels down, which may fall too
much. Eating too many carbohydrates has a similar effect, in addition to
increasing blood sugar levels.
|
| Q: |
Why do I have a migraine attack when I stay up too late or sleep too late?
|
| A: |
The body’s biological cycles are regulated by the hypothalamus,
which controls release of serotonin, which induces sleep, and
epinephrine, which has an activating effect. In migraine, due to a
disturbance in serotonin activity, epinephrine release is poor. This is
the most likely reason why sleep disruption can trigger migraine.
|
Myth or truth?
Myth
“Menstrual migraine is unavoidable”
Truth
Although menstrual
migraine is the result of an internal trigger—the drop in estrogen
levels just before menstruation—it is more likely to occur or to be more
severe if other triggers are also present. Therefore, avoiding other
triggers, such as sleep disturbance or missing a meal, is just as
important for those with menstrual migraine as it is for anyone with
migraine. By controlling the number of triggers present during the week
before menstruation, menstrual migraine can be more easily treated or
possibly avoided completely.
