Neurol. praxi. 2025;26(6):465-470 | DOI: 10.36290/neu.2025.034

Management of migraine in a woman

MUDr. Radka Marková, MUDr. Halina Hevková

Neurologické oddělení, Nemocnice Havlíčkův Brod

Migraine is a chronic neurological disease that affects 15-20 % of women of reproductive age. Migraine treatment in women involves specific approaches due to hormonal influences. Estrogens play a key role in menstrual migraine, which often occurs during the luteal phase of the cycle. Migraine is three times more common in women than in men, with differences becoming apparent after puberty. Hormonal changes, including the menstrual cycle, pregnancy and menopause, contribute significantly to the higher prevalence of migraine in women. Female gender is also a risk factor for chronic migraine and overuse headache. Pregnancy and breastfeeding place specific demands on the choice of treatment, as it is necessary to ensure effective seizure control while minimizing the risk to the fetus or infant. This article provides an overview of the current findings on the acute and preventive treatment of migraine in childbearing age, during pregnancy and breastfeeding, with an emphasis on the safety of key antimigraine drugs. A special space is devoted to calcitonin gene-related peptide (CGRP) antagonists.

Keywords: migraine, fertility, pregnancy, menopause, CGRP receptor antagonists, hormonal contraception, teratogen, gepants.

Received: March 31, 2025; Revised: March 31, 2025; Accepted: April 7, 2025; Prepublished online: April 7, 2025; Published: December 15, 2025  Show citation