Tepper Stewart J
Yale University School of Medicine, New Haven, CT, USA.
Headache. 2006 Oct;46 Suppl 2:S61-8. doi: 10.1111/j.1526-4610.2006.00556.x.
Many women report an increased frequency of headaches around the time of menses. For some women, these headaches are more severe, of longer duration, and lead to greater disability than those occurring at other times in the menstrual cycle. A headache diary is critical to properly diagnose menstrual migraine (MM) by prospectively documenting headache days, severity of headache, and the headaches' relationship to menses. In women with diagnosed MM, acute treatment has been proven to be effective in randomized clinical trials. For those women who have predictable periods and may require preventive therapy, short-term prevention is a reasonable approach due to the predictability of MM. Although several agents (eg, naproxen sodium, magnesium, triptans) have been evaluated for prevention of MM, all but triptans have been assessed in small trials of between 20 and 35 women. Naratriptan, frovatriptan, and, most recently, zolmitriptan have been proven effective in preventing MM. Triptans are generally well tolerated, and the long-term safety of these agents is currently being evaluated. The flexibility of using acute and preventive therapy allows physicians to tailor treatment of MM and meet the needs of individual patients.
许多女性报告称，在月经期间头痛发作频率增加。对一些女性来说，这些头痛比月经周期其他时间出现的头痛更严重、持续时间更长，导致的功能障碍也更大。头痛日记对于通过前瞻性记录头痛天数、头痛严重程度以及头痛与月经的关系来正确诊断月经性偏头痛（MM）至关重要。在已确诊MM的女性中，急性治疗在随机临床试验中已被证明是有效的。对于那些月经周期可预测且可能需要预防性治疗的女性，由于MM的可预测性，短期预防是一种合理的方法。尽管已经评估了几种药物（如萘普生钠、镁、曲坦类药物）用于预防MM，但除曲坦类药物外，其他药物均在20至35名女性的小型试验中进行了评估。那拉曲坦、夫罗曲坦以及最近的佐米曲坦已被证明对预防MM有效。曲坦类药物一般耐受性良好，目前正在评估这些药物的长期安全性。使用急性和预防性治疗的灵活性使医生能够调整MM的治疗方案，满足个体患者的需求。
