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Imitrex and Fioricet stopped working for hormonal migraines

I feel a sense of relief to have even found such a forum! I've been suffering from hormonal migraines for over 10 years, and only in the past two years did I seek treatment with my doctor. 95% of my migraines are triggered by my periods (with on occasional one due to lack of sleep or stress). I get one a day or two before my period starts, and I get a second one as it's ending. My doctor started me with Fioricet, which worked for a few months, and then stopped working. I then switched to Imitrex, which worked for almost two years. My past few cycles have been horrendous with my migraines. I take 150mg of Imitrex, and it will make it go away if I take it right at the start of it. But then it will come back a day or so later. The same happened with Fioricet.

I would love some guidance or advice on if it's common for medications to stop working, and if anyone has had any luck with certain medications for migraines due to hormonal changes. I don't know if maybe I need a stronger dose of either Fioriciet or Imitrex, or if something else would be better.

I know this is really a question for my doctor, and I need to work on this, but I tend to be that person who will put off seeing a doctor unless I know there are better options out there for me. I end up feeling so defeated before I even make an appointment.

The only thing that is mostly a fool-proof cure for me is sleep. If I sleep for 12-14 hours during a migraine, I will usually wake up and feel 80-90% better, and it will stay away. But I just can't always do that. Right now I feel like my periods totally dominate my life because my cycle is also every 24 days, so sometimes it's three migraines a month. For those with chronic migraines, I honestly don't know how you do it. I get such horrible anxiety when I know my period is coming because I think to myself, "will my medication work this time, or will I be at work worried about how I will drive home because keeping my eyes open is incredibly painful?

Any and all advice or suggestions welcome at this point. Thanks for letting me vent 😀

  1. Thanks so much for sharing some of your journey with us. Having hormonal changes are a very common trigger for migraineurs. Kind of like barometric pressure shifts, these are things that are primarily out of our control and can lead to some of the most stubborn and extreme migraine attacks. That said, there are some ways to manage hormonal migraine. First, you are right, we cannot provide medical advice here - however, we can give you support, information and guidance on the topic of migraine.
    Like you, hormones are one of my primary triggers. Many years ago my migraine doctor suggested I connect with my GP to try a continuous birth control pill as a way to manage this trigger. This means I take a low dose birth control pill literally continuously without taking the 'sugar pill' week. Doing so prevents one's system from having a period as frequently as you would otherwise. This has worked tremendously well for me. There are other birth control methods that can also limit/decrease your cycle. It would be well worth discussing these options with your OB or GP at your earliest convenience since this is your primary trigger and leads to such intense migraine attacks. If a birth control method such as this doesn't make sense for you for whatever reason, it is likely time for you to discuss some kind of preventative medication, rather than just a rescue medication, with your doctor, that you could take when your period is coming since you know that schedule. There are various medications, or different ways to take your triptans, when you know a migraine is coming in order to prevent it, rather than waiting until it has actually hit. Here's some information on preventatives:
    I hope this helps to get you started in your thinking. I also wanted to share with your our resources on hormonal migraine:
    You are not alone in this! We are here for you and in this with you. Stay in touch and know we're thinking of you. Warmly, Holly ( team).

    1. That's such a shame about the migraine specialist! Some doctors really are awful. :\ When it comes to reviews, I like to check a variety of sources while keeping in mind that people with bad experiences are typically more likely to leave a comment than those who are satisfied. Might be worth a shot anyway, just to see for yourself -- maybe a telehealth appointment so you can get a feel for them and see if what you're reading seems true. Of course, we support whatever you choose. Hang in there! -Melissa, team

    2. The shortage of migraine specialists is so unfortunate. I'm sorry to hear about those negative reviews. A neurologist that specializes in pain can be a good fit. Would love to hear how your appointment goes with your primary. Thinking of you- Holly ( team).

  2. Thank you, ladies! Yes, I did look at a few different sites for doctor reviews, and unfortunately, this one in particular had horrendous reviews all around for unprofessionalism, misdiagnosis and leaving patients waiting in exam rooms for hours. Yikes. My primary care appointment is later this week, so hopefully there will be some progress made there.

    1. Sounds like you've really done your homework. We'll be thinking of you and hoping your appointment this week goes well. We can brainstorm other options if for any reason you need to after that appointment. Thanks for staying in touch. Warmly, Holly ( team).

  3. Hi all! Just a quick update. I had my appt with my primary care doctor, and I do feel much better. While their office doesn’t prescribe BC to patients over 35 with migraines because of the stroke risk, she did say that she has patients over 40 who use it and that OBGYNs will usually be the ones who prescribe it since estrogen levels are their specialty. She said I should have no issue getting it since I’m not a smoker, I don’t experience Aura, and my base levels are perfect (idea blood pressure, cholesterol, etc). She was actually taken aback when I told her my old OBGYN wouldn’t prescribe it and supported my decision to find someone new because she said many of her patients over 40 have found great relief with the BC. I recently decided to switch my OBGYN and got a new patient appt with someone who is very highly rated, but of course she was a 6-month wait for new patients. I decided it was worth the wait. I explained all this, as well as my migraine situation to my primary, and she suggested a new triptan called Eletriptan. She said many of her patients report that it works much better for eliminating and keeping migraines away during attacks. She was very kind, and said she’s happy to help me manage my pain until I can get in with my new OBGYN in January of next year. So while it wasn’t exactly the result I was hoping for, I do feel heard and supported by my doctor, and feel hopeful that if I can wait it out a bit longer, I can go on BC and just prevent them all together. My next period is due in a week and a half, so I’ll try to report back how the Eletriptan works in case anyone finds it helpful. Usually newly-prescribe medications work well the first few months, though, so it may not be the same come January!

    Thank you all so much for the support and encouragement! It was honestly exactly what I needed.

    1. @Anonymous928 It's so nice to hear that you have such a good relationship with your primary care doctor. It is so important that we feel heard by our doctors. I hope the Eletriptan works well for you until you get in to see your new OBGYN. I know the waiting can be hard, but I'm trusting it will be worth it in the end! Warmly, Cheryl team

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