Key TakeawaysResearch shows that for 50% of people who experience migraines and menstruate, the hormonal changes surrounding menstruation can be a migraine trigger.Menstrual-related migraines can be hard to treat because the symptoms may not respond to the medications that are used to treat other types of migraines.A new technology called remote electrical neuromodulation (REN) has been shown to be effective at treating other types of migraines. Now, researchers say the device may also provide non-drug relief of symptoms for menstrual-related migraines.
Key Takeaways
Research shows that for 50% of people who experience migraines and menstruate, the hormonal changes surrounding menstruation can be a migraine trigger.Menstrual-related migraines can be hard to treat because the symptoms may not respond to the medications that are used to treat other types of migraines.A new technology called remote electrical neuromodulation (REN) has been shown to be effective at treating other types of migraines. Now, researchers say the device may also provide non-drug relief of symptoms for menstrual-related migraines.
Compared to othertypes of migraines, menstrual migraines do not always respond well to the typical treatments, such as medication.
To address the treatment gap, researchers have been evaluating a wearable device calledNerivio, which uses a drug-free pain relief method called remote electrical neuromodulation (REN).
Are Migraines Related to Your Period?
What Are Menstrual Migraines?
Migraine symptoms related to the menstrual cycle are common, affecting over 50% of people who menstruate.Hida del Carmen Nierenburg, MD, a neurologist and headache specialist withNuvance Health, tells Verywell that a person who experiences menstrual migraines gets migraines during menstruation as well as at other times of the month.
Pure menstrual migraine (that only happens during menstruation) is rare, affecting only about 12% of people who menstruate. These migraines occur anywhere from two days before to three days into a person’s menstrual period.
“Menstrual migraines tend to be tougher to treat, and the pain is more severe, for unclear reasons,” says Nierenburg. “The way we treat menstrual migraines is sometimes with birth control (oral contraceptives), but the studies are outdated. There’s very little adequate or recent research evidence supporting effectiveness, and for some women, oral contraceptives can make migraines worse.”
Menstrual migraines may not respond to the medications that are typically used for migraine headaches—and it’s not clear why.
Some people with menstrual migraines manage their symptoms through “mini-prophylaxis” withnon-steroidal anti-inflammatory medications(NSAIDs) andtriptans(the standard acute treatment for migraine), which they take for several days during the expected attack.
However, some people cannot use this method because of medication side effects andallergies to NSAIDs.Non-medication alternatives are needed for these people as well as for people for whom these treatments have not been successful.
Can Birth Control Pills Treat Menstrual Migraines?
What Is Nerivio?
How Does Nerivio Work?Nerivio is a small, discreet, REN device. Users wear it around their upper arm for migraine pain relief as needed. They can control the device via Bluetooth and the device’s accompanying smartphone app.
How Does Nerivio Work?
Nerivio is a small, discreet, REN device. Users wear it around their upper arm for migraine pain relief as needed. They can control the device via Bluetooth and the device’s accompanying smartphone app.
The device applies an electrical stimulus to the upper arm. It is not painful for the wearer, but the signal “tricks” the nerves in the arm into perceiving the sensation of pain.
This, in turn, causes the pain centers in the brainstem to become activated. When this happens, the brain stem releases neurotransmitters—such as norepinephrine and serotonin—to help relieve the pain.
Using a TENS Unit for Pain Management
What Does the Research Say?
The researchers gathered information from a retrospective survey that included 91 women between the ages of 18 to 55 who experienced migraines around the time of their menstrual cycle.
Of these women, 68 women (75%) reported at least a moderate relief of their migraine symptoms while they were wearing the REN unit.
The researchers also found that two-thirds of other migraine patients also experienced pain relief after two hours of using Nerivio.
Migraines and Teens
Minimal Side Effects and Risks
Another advantage to REN is that it has minimal side effects. In the trial, 12 of the 91 people who used Nerivio reported mild side effects such as bruising on their arm where they had been wearing the device, nausea, and dizziness.
The device also does not have the potential to interact with other medications that a user might be taking because it is a drug-free pain relief method.
“Migraine patients are sensitive to overuse of rescue medications," says Nierenburg. “Taking triptans or over-the-counter medications such as combination analgesics with acetaminophen and caffeine more than 10 days a month can cause them to have more headaches.”
Who Else Could Nerivio Help?
People who used REN therapy to treat their menstrual migraines also reported a decrease in other menstrual-related pain, including cramps (38% decrease) and pelvic pain (37% decrease).
These findings have led the researchers to believe that REN therapy could also be helpful for other types ofchronic painthat are difficult to treat with medication.
Using the protocol created for the research, Nierenburg has also successfully treated patients with chronic migraines that are tough to manage.
Nerivio might potentially be used for other types of pain in the future, but Nierenburg says that other indications for the treatment have not been studied yet.
It’s clear that there are benefits to using a drug-free pain relief method like Nerivio that go beyond efficacy; Nierenburg points out that for patients who need pain relief without the sedation that can come with some treatments (such as people who drive for a living or operate heavy machinery), a device like Nerivio could be a good option.
What This Means For You
Can Menopause Make Migraines Worse?
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Nierenburg H, Rabany L, in T, et al.Remote Electrical Neuromodulation (REN) for the Acute Treatment of Menstrual Migraine: a Retrospective Survey Study of Effectiveness and Tolerability.Pain and Therapy. June 17, 2021:1-9.doi:10.1007/s40122-021-00276-7
Cleveland Clinic.Menstrual Migraines (Hormone Headaches).
Theranica.What Is CPM?.
Hershey AD, Irwin S, Rabany L, et al.Comparison of Remote Electrical Neuromodulation and Standard-Care Medications for Acute Treatment of Migraine in Adolescents: A Post Hoc Analysis.Pain Medicine. June 29, 2021. doi:10.1093/pm/pnab197
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