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"Why do I get migraines at least once a month?"
I am a 25 year old female with regular periods each month. I am married with no kids. I am on the birth control medication Yaz, and have been taking birth control pills for 10 years. I drink about one caffinated beverage per day. I experience moderate stress on the job. Should I see a neurologist about my migraines, or could it simply be related to hormones and/or stress?
There are many different types of headaches that people experience - tension, menstrual-related, cluster, or migraine, to name a few. If you have not been given a diagnosis of migraine, then you should talk to your doctor about trying to identify which type of headache you are suffering from. Migraines are often diagnosed in young women such as yourself, and classically cause a one-sided, pounding headache of at least moderate intensity. They are sometimes associated with nausea and visual changes, and usually get worse with any kind of activity, bright light, or loud sounds. Migraines tend to run in families, and it is thought that there is some kind of genetic predisposition towards developing this problem. Patients identify different triggers for their headaches; some list foods such as alcohol or caffeine or chocolate, whereas others list stress or menstrual cycle. Fortunately, your headaches are coming only once a month and not more frequently. For this type of frequency, I would suggest trying to identify your triggers by keeping a headache diary. You should also talk to your doctor about having some kind of abortive medication which you can take when you feel a migraine coming on (eg Ibuprofen, Tylenol, a triptan, etc). If your migraines start coming more often, then you should talk about the benefits/risks of taking a daily medication as a form of prophylaxis. Furthermore, migraines are a relative contraindication to taking oral birth control pills; you should consider finding another form of birth control if your headaches cannot be controlled otherwise.
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