i used to have my migraines mapped out pretty well. the perimenstrual ones, specifically - three days before my period, guaranteed, aura in the late afternoon, then a nurtec and it would usually be done in 90 minutes. maybe some lingering postdrome brain fog the next day, but the attack itself was pretty much over. now with perimenopause, it’s like the whole system is broken.
cycles are all over the place, sometimes 45 days, and the migraines themselves are different. i’m getting these multi-day ones, where an abortive takes the edge off but it doesn’t really stop the migraine. like, the pain might go down from a 9 to a 4, but it just hangs around for another day or two. sometimes i’ll take another dose of my triptan or nurtec 24 hours later, but it feels like i’m just trying to keep it from exploding back, not actually killing it.
i always thought a migraine had a clear start and end, and an abortive was supposed to get you back to baseline in a few hours. but these longer ones, where it just sort of lingers and then fades out over two days even with meds, it makes me wonder if i’m misunderstanding what a migraine is supposed to look like in the first place. or if perimenopause just makes everything messy. does anyone else get this?
where your abortive doesn’t fully clear it, and you just have this low-grade migraine or really intense prodrome/postdrome blend for days? is that still considered one migraine attack, or is it just a string of smaller ones? my neurologist mentioned the ajovy sometimes plateauing for me, but we haven’t really talked about abortives not fully working like this. it’s just exhausting.