Question

I get cyclical migraines 7 days before my period (normally for 3 days). Last month I had one for 4 days and then discovered I was pregnant; I was thrilled. A month later I got the WORST cluster migraine ever with 2 days of an ice- pic headache on top! I found out I had a silent miscarriage at 9 weeks. I got pregnant right away and my period was due yesterday and I have a migraine.

Is a chemical miscarriage on its way? Could I have a progesterone deficiency? I have had these cyclic migraines on and off for 15 yrs. My breasts did not feel as tender yesterday. Please help me. Thank you

Zara

Answer

Dear Zara,

First of all, if you are pregnant again, you definitely want to see a physician who can start you on progesterone 200 mg intramuscular injection twice a week and check a trough progesterone level. Whether or not your cyclic headaches are related to low progesterone, you are at risk of another miscarriage.

If you are not pregnant then you should be evaluated for a luteal phase defect and low progesterone levels. They very well may trigger or worsen migraine. To find a doctor who can help you, check the following websites: www.fertilitycare.org (click on Medical Consultants) or www.omsoul.com (click on NFP Directory) or www.canfp.org

George Delgado, M.D., F.A.A.F.P.

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