Menstrual Abdominal Migraine: An Observational Study

Abstract

Objective: To evaluate abdominal pain of menstrual origin in mothers of children with migraine.

Materials and Methods: A 4-year observational study (April 2004–September 2008) was conducted at the Eye and Migraine Centre, Cherthala, and St. Sebastian's Visitation Hospital, Arthunkal. Four thousand mothers with migraine (migraine without aura, migraine with aura, and probable migraine) were interviewed regarding menstrual headache and abdominal pain while accompanying their children with migraine headaches. Migraine diagnoses were based on the International Classification of Headache Disorders, 2nd Edition (ICHD-2) criteria.

Results: Only 14% (562) of women had menstrual migraine, whereas 72% (2,882) reported dysmenorrhoea either currently or in the past. Among them, 61% (2,441) experienced severe lower abdominal pain associated with migraine-related features such as anorexia, nausea, vomiting, phonophobia, and photophobia, suggesting lower abdominal migraine. The pain commonly lasted one day, significantly affected daily activities, and often improved after the first pregnancy.

Conclusion: Severe lower abdominal pain resembling abdominal migraine is common among female migraine sufferers during menstruation and may occur even in the absence of typical migraine headache. The author recommends specifically enquiring about dysmenorrhoeic symptoms with migrainous features during headache evaluation, as recognition of this migraine trait may facilitate earlier diagnosis of migraine in affected children.