The current patient’s headaches meet the International Headache Society criteria for migraine without aura. As her headaches occur in association with her menses, as well as other times of the month, she can be given the diagnosis of MAM, although this sub-classification of migraine is not recognized in the International Headache Society (IHS) classification.
She responds very well to tryptan therapy you initiated. What frequency of follow up is warranted and what non-pharmacologic options might help in decreasing the severity and frequency of her headaches?
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