What is the best prophylaxis for menstrually related migraines?
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Use of perimenstrual triptans (from 4 days prior to menses through 2 days after onset of flow) reduces the number of days with menstrually related migraines compared with placebo (SOR: A, consistent RCTs). Perimenstrual transdermal estradiol gel likely also reduces perimenstrual migraine occurrence (SOR: B, single RCT).
Evidence Based Practice 15(12): 18-19.