Hormonal Migraine Treatment with Propranolol

Written by rena sherwood
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Hormonal Migraine Treatment with Propranolol
Artist's interpetation of what a hormonal migraine is like. (Image by Flickr.com, courtesy of Migraine Chick)

Propranolol (brand name Inderal) is a popular and inexpensive prescription beta-blocker medication used to treat high blood pressure. According to the book "Menstrual Migraine," doctors also prescribe propranolol off-label for many types of migraines in women, including hormonal migraine (menstrual migraine). Using a drug off-label means that the drug is being used for something other than it has been approved for.

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Time Frame

When used to prevent hormonal migraines, propranolol is taken every day. It cannot help get rid of pain once a migraine attack starts. Depending on the dosage, patients may take one to three pills a day. It may be a couple of months before the patient notices any reduction in the number of migraines she has in a month.

Dosage

According to the journal American Family Physician, propranolol for migraines needs to be taken in doses of 80 to 240 mg per day, usually in three or four separate pills instead of all at once. The patient would start taking propranolol at a low dose for one or two weeks to be sure the body can handle it and then gradually increase the dose. The goal is to take the least amount of propranolol yet still be able to prevent migraines.

Alternatives

According to "Menstrual Migraines," the drugs of choice to help prevent migraines are low-dose oral contraceptives or hormonal replacement therapy (HRT) such as Premarin (derived from pregnant mare urine). But some women with migraines cannot take these drugs or refuse to take them because they support animal rights. "Menstrual Migraines" also notes that HRT may contribute to the frequency of hormonal migraines.

Consideration

According to "Migraines For Dummies," a woman who also suffers from hormonal migraines may also suffer from other types of migraines, including classic migraine (also called migraine with aura), migraine without aura or chronic daily migraines. Propranolol can help prevent these types of migraines as well.

Speculation

It is unknown why propranolol can sometimes help prevent hormonal migraine attacks because it is unknown exactly why people get migraines. One theory is that it helps to keep blood vessels in the meninges (protective tissue in between the brain and the skull) from swelling after a woman experiences a drop in oestrogen. After a drop in oestrogen that can happen before menstruation or during menopause, this triggers a drop in the neurotransmitter serotonin, which then activates more chemicals to expand the blood vessels in the meninges in the head.

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