The Healthy Blogger

Menstrual headaches and menstrual migraines

I often get headaches for the few days surrounding my cycle, but I don’t believe I truly suffer from menstrual migraines.  Yet, I do believe that some of those headaches are migraines and a few may be related to the menstrual cycle.  However, I do not suffer from the regularity of true menstrual-related migraines.

Menstrual migraines are believed to be associated with the drop in estrogen that is seen at the end of a monthly cycle (and the beginning of menstruation).  It can start anytime from about 2 days before the flow of menses and end a few days after.  Migraine sufferers may only experience these headaches around their cycle, while others may have their migraines exacerbated by it.  Yet, inexplicably, others may experience migraines outside this relationship.

Symptoms of menstrual migraines are similar to any other migraines.  Some experience auras while others may not.  The headaches are usually one-sided, though it may spread to the other side, and are usually described as pounding.  The severity differs from individual to individual and episode to episode, but it can be quite severe.  Other associated symptoms, such as visual disturbances, nausea/vomiting, dizziness, and confusion may be present.

I do get migraines and most of the time, I get the nausea/vomiting/dizziness more than the headache.  It can be quite incapacitating.  These migraines are usually triggered by some kind of stress, but sometimes the only “stress” I can identity is the start of the cycle.  That is why I believe some of them are menstrual migraines.  However, because I do not get them every month, I do not consider myself one of those who have a true diagnosis of menstrual migraines. 

I make this clarification because in recent years, menstrual migraines have been getting public attention, especially when drug companies are trying to market medications for the treatment of such things.  I am not a pill pusher and do not like the idea of taking a pill for anything and everything.  However, I am not averse to taking some Tylenol for pain occasionally. 

I may not get migraines, but I often get headaches around my cycle.  I attribute this to the tightening in the muscles in my upper back and shoulders as a result of cramping.  I know this must be the case because I can feel the tension as I do neck exercises to work it out, or when I massage myself and can feel the pain in the muscles from the scalp down to the upper back and shoulders.  I just wish I had more willing masseurs.  It’s hard to reach back and give yourself a massage without causing other parts of your arm to go sore.

Headaches are common, but it’s surprising that menstrual migraines are also very common amongst women.  It may explain why migraines are much more common in women than in men.

When to stop cervical cancer screening?

There’s on-going debate about when cervical cancer screening should be stopped.  Current UK recommendations suggest that those over 50 should have screening every 5 years, whereas those between 25 and 49 should be screened every 3 years.  This is much less frequent than in the US, where screening is every year.  This decreases to every three years if you are over 30, have never had an abnormal smear, and in a monogamous or low-risk relationship.  If there is a change in the relationship, it is recommended to undergo screening yearly until stable.  Women over the age of 65 and have never had an abnormal smear are given the option of not having any more tests.

But UK researchers are worried about calls to end screening in women over 50.  They found that although few women have abnormal smears, about 1% will show abnormalities.  They did not comment on the severity of the abnormality or whether it required intensive treatment.  Statistics show that most cervical cancer occurs in young women, under 35 years of age.  Most of the cases are due to infection with HPV, which is sexually-transmitted.  However, the HPV may remain dormant and cause problems later in life, so some cancers may occur in those older than 35.

It’s interesting to note that they would consider ending the programme of screening in women over 50.  After all, you cannot say that women over 50 suddenly stop having sex.  In fact, many of them are still very active.  Some have entered into late-life relationships with new partners.  Some of these partners may be much younger themselves.  I remember attending an infection control seminar where it was reported that some older women were coming home from cruises, where they had “one-night stands” with a fellow passenger, with sexually-transmitted diseases, including HIV.

There is this public perception that older people do not engage in sex.  Perhaps, it’s like denying your own parents having sex.  So, until someone is free and clear of the act, they should probably continue to be screened for cervical cancer.

On the flip side, I can never understand why some women insist on having smears done when they’ve undergone complete hysterectomies.  Is it because their doctor is trying to get extra payment?  I would not be in a hurry to have it done unnecessarily.