My mother has been suffering with migraines for over 23 years. They started just after she gave birth to my brother. He was delivered by caesarean section and before they closed her up, they performed a tubal ligation. Soon after, she began to experience migraines once a month just before the start of her period. She tried many different prescription medications including Imitrex, which provided some but not complete relief. About 8 years ago, she underwent a hysterectomy, which she hoped would alleviate her migraine pain since they seemed to be related to her menstrual cycle. However, her migraines persist in a similar pattern occuring almost every month. She is not taking any hormone therapy. I am wondering what could be causing her migraines to continue, and were they even related to her menstrual cycle to begin with? Could her migrains have anything to do with the tubal ligation? Any insights would be appreciated.