Hormones, Miscarriages, & Migraines
My migraines tend to follow patterns. The ones triggered by the weather are often easier to abort, last less time, and have fewer side effects. Alternatively, the ones triggered by my hormones are easily much more devastating. They can last for days on end, despite the strongest abortive medications available to patients at home. They usually require darkness, silence, antiemetics, removal of all screens, and excessive amounts of sleep - also known as life has to be put entirely on hold for much more time than I’d like to admit.
Hormones and pregnancy loss
After going through fertility treatments this past year, I experienced two early miscarriages. I noticed that my regular period cycle and some of my previous treatments had caused repeat and severe headaches. Still, I was completely caught off guard when after the first miscarriage, I found myself with the worst migraine I’d had in decades. Apparently, the combination of high-level hormones with a rapid increase and then decrease, along with excessive bleeding, really did a number on me.
Desperate for relief from the worst migraine
At the time, I had only been managing some smaller, more benign migraines for a few years and didn’t have any of the tools on hand to get me through. I’d been seeing a neurologist who unfortunately was not a migraine specialist, and she was unable (and unwilling) to offer me alternative support. After 5 days of truly suffering, I walked into the emergency room and begged for help. It took about six hours and several pushes of IV medications to find some relief.
Anxious about a repeat attack
In the recovery period from that migraine, I developed incredible anxiety about a repeat experience.
When I was able to establish care with a new neurologist, I started by explaining this anxiety. I had an abortive medication at home when the devastating migraine struck, and it did nothing to reduce my symptoms. What if it happened again? As someone who is immunocompromised, living in the midst of a global pandemic, I grew to fear the need to return to the crowded ER with the onset of another debilitating migraine.
Working treatment options around my fertility plan
When developing a migraine management plan, my doctor discussed several different types of migraine medication and what he thought would be best suited to my situation. As someone actively still trying to conceive, many of the preventative medications were off the table. Without enough data, they are considered unsafe or risky for pregnancy, which meant I wasn’t able to try them. There were a few abortive options he recommended - and having more than one choice on hand would give me the option to alternate or combine medications - hopefully breaking up harder migraine cycles.
Finding an option that might work
The real piece of anxiety relief came next.
My doctor asked me how I felt about injections. When I told him that In Vitro Fertilization has made them commonplace in my home, he recommended an as-needed intramuscular injection medication called Ketoralac for unbearable migraine pain. Although a small dose, the injectable medication would provide faster, ER-style relief in the comfort (and safety) of my home.
Did relief come?
My insurance approved 4 injections a month, and having them on hand has been the biggest sigh of relief I have had in a long time. In the six months since this was prescribed, I have used 6 injections, and I have been overwhelmingly grateful each time that I have been able to cut my migraine duration down significantly.
My neurologist was on my side
I continue to have regular check-ins with my neurologist, but I am so thankful to say I haven't needed the ER for migraine help since I began seeing him.
I'd love to know if you've experienced an increase in migraines due to hormones, menstrual cycle, fertility treatments, pregnancy or pregnancy loss, and how you've managed them.
How much has your migraine disease changed or evolved over time?