The association between menstruation and migraine headaches may start to become evident during adolescence, according to findings published in the March issue of Headache.

Menstrual migraine is well-recognized in adult populations but not in adolescent populations, Dr. Andrew D. Hershey, of Children’s Hospital Medical Center, Cincinnati, Ohio, and colleagues point out.

“Whether the onset of menstrual migraine is associated with the onset of menstruation or develops with time is unknown,” they note. There is little information on when menstrually related migraine first occurs.

The researchers conducted a review analysis of headache characteristics in 896 consecutive girls between the ages of 9 and 18 years. Of the 896 girls, 331—50.3 percent of those who had just started to menstruate and 36.9 percent of all girls—reported experiencing headaches with the menstrual period.

Overall, 77 subjects (63.6 percent) who reported a menstrual pattern noted that migraines started between day -2 and day +3 of their menstrual period start. Associated symptoms were increased among girls with menstrual migraine compared to those without menstrual migraine. No difference in disability was observed between girls with a menstrual pattern and those without a menstrual pattern.

In addition, 160 subjects reported a monthly pattern to their headaches despite not having a menstrual period or having just started menstruation.

These findings suggest the migraine related with menstruation begins before the onset of menstruation, “which implies that menstrually related migraine is a hormonal event sensitive to the fluctuations in hormonal levels that can precede menstruation,” Hershey’s team concludes.

SOURCE: Headache, March 2009.