Giving Hope to Women with Menstrual Migraine
Dr Lakshini Gunasekera, Catalyst Grant recipient
In a massive win for women's health and headache medicine, Dr Lakshini Gunasekera, a neurologist and headache specialist from Alfred Health and Monash University, has been awarded a $131,000 Catalyst grant from the Victorian government. The funding will support a groundbreaking clinical trial to investigate hormonal therapies for MRM, a critical step toward offering relief to countless women.
For millions of women around the world, migraines are not just a bad headache—they are a debilitating condition that can severely disrupt their lives. And for many, these painful episodes are tied to their menstrual cycle, a subtype known as menstrually-related migraine (MRM). It is a condition that is often more severe and resistant to standard treatments, and research into effective therapies has been lacking—until now.
A New Hope for a Neglected Condition
It is estimated that three out of four migraine sufferers are female, yet MRM remains a significantly neglected area of research. Current treatments for MRM are often a combination of non-steroidal anti-inflammatory drugs and triptans, but these don't always work. Dr Gunasekera's new study will address this gap by evaluating the use of a newer generation oral contraceptive pill, Zoely (nomegestrol/estradiol).
Unlike older contraceptive pills that use synthetic estrogen, Zoely's estrogen component (estradiol) is the same hormone naturally produced by the ovaries. This physiological similarity is key. It is believed that the sharp decline in estrogen during a woman's menstrual cycle plays a major role in triggering MRM. By maintaining a consistent level of estrogen, Zoely may prevent these attacks.
Critical preliminary research from co-investigator Professor Jayashri Kulkarni has shown that Zoely can have positive effects on mood. Given the high co-prevalence of mood disorders like depression and anxiety in migraine sufferers, this could offer a significant added benefit.
A Team of Experts Working for Women's Health
This randomised-controlled study is not just about finding a new treatment; it is about giving women their lives back. If successful, the trial could lead to reduced disease severity, fewer hospitalisations and outpatient visits for migraine treatment, and a dramatically improved quality of life for those with MRM.
Dr Gunasekera, who has a lifelong passion for improving outcomes for women with migraine, will work within a multidisciplinary team* to address this challenge. The team includes experts in headache medicine, psychiatry, and neurology from Alfred Health and Monash University. Together, they bring a wealth of knowledge to this niche area of clinical neglect.
Dr Gunasekera is a second-year PhD candidate at Monash University. With her extensive background in neurology and research, and with the support of her expert team, she is ready to lead the charge in finding a safe, effective, and well-tolerated therapy for menstrually-related migraine.
This trial represents a monumental step forward in women's health and offers a beacon of hope for all those who have suffered in silence.
* The multidisciplinary team undertaking this study along with Dr Gunaskera includes Dr Elspeth Hutton, neurologist; Professor Jayashri Kulkarni, psychiatrist; Professor Helmut Butzkueven, neurologist; Professor Terence O’Brien, neurologist; and Dr Shobi Sivathamboo, Senior Research Fellow and Laboratory Head.
About Monash University
Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
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