Migraine
Why women are more at risk
The symptoms can be crippling – an intense headache, blurred vision, nausea and vomiting. Sometimes people can experience flashing lights; sensitivity to light, smells and noise; confusion and difficulty concentrating.
This is what migraine feels like for about 4.9 million people in Australia, most of them women. Yet, according to research, this medical condition remains misunderstood, underdiagnosed and under-treated.
Here we uncover why women are more at risk of migraine and what you can do if you experience migraine.
The family effect
Up to 70% of migraine sufferers are women, says Dr Elspeth Hutton, a neurologist and Head of Headache Service at the Alfred Hospital in Melbourne. She explains that migraine often runs in families and it tends to emerge more often in women in the family.
“This is because hormonal variations – such as starting to get periods, pregnancy and perimenopause – can be a trigger,” she says.
The fact that it does run in families has also helped to ‘normalise’ migraine. This means many women tolerate the pain without ever seeking medical treatment.
“Often girls and women grow up seeing their mother or aunt regularly needing to lie down in a dark room or taking pain killers to try to deal with their migraine. So it’s seen as a routine part of life to struggle through – just a normal part of life,” says Dr Hutton.
“It’s similar to the perception that painful, heavy periods are just part of the ‘female lot’.”
Know the difference
So how do you tell if it’s migraine or a headache?
If the pain stops you from engaging in normal activities and carries other symptoms like nausea, vomiting, a sensitivity to light or smell, or feeling dizzy, and if it happens on a regular basis, you probably have migraine.
How often migraine episodes occur can vary from person to person, but if you experience it on 15 or more days a month, that means you are suffering from chronic migraine. About 20% of people with migraine report aura – they see zigzag lines or flashing lights, have blind spots or have difficulty focusing.
Triggers
For many people, stress is a common trigger for migraine. So too is a lack of sleep, skipping meals or eating foods like chocolate or certain cheeses, as well as drinking alcohol.
For women, hormones add another layer. Migraine in women is often the result of changes in levels of hormones, particularly oestrogen. This can happen just before the start of your period, triggering what is known as ‘menstrual migraine’.
Moving into perimenopause (the lead-up to menopause) can also trigger an increase in migraine because of hormonal fluctuations. Migraine episodes often improve after menopause, but it’s still important to take action.
Patient advocate and Director of Migraine and Headache Australia Carl Cincinnato encourages women to speak to their doctors during these challenging times about preventive treatments for migraine.
What to do if you think you have migraine
Seeing a GP is the first step. While migraine is common, there can be a lack of professional training and understanding among some health professionals, says Dr Hutton. “In our headache clinic, it’s not uncommon for people to tell us they’ve had these headaches for 10 to 20 years, and no one told them it was migraine.”
Dr Hutton says treating migraine early in the episode is best. “We often prescribe a high dose of soluble aspirin or ibuprofen at the onset of migraine.”
Medications known as ‘triptans’ are another good option.
Whatever is used, patients must discuss treatment with their doctors and be aware of the problems of overuse, she explains. “They should not take pain relief more than 15 days per month, or triptans more than 10 days per month.
“If they exceed this, they risk their migraines becoming more frequent, severe and harder to treat.”
Mr Cincinnato believes that the best prescription for migraine is education. “Give yourself a good understanding of what migraine is and how it affects you. Keep a diary. Look at the triggers for the attack, and that can vary from person to person.
“Try to keep your diary entry to one page so the doctor can easily evaluate the severity and frequency of your attacks, and put together an appropriate management plan.
“There may be some trial and error with individual treatments. What works for some may not work for others, but there are treatments that can help to significantly reduce the burden of migraine.”
Taking control
While migraine is a complex condition, Mr Cincinnato says that you are the most important person in managing it. “We are the CEO (chief executive officer) of our own health care,” he explains.
“We have greater ability to control this condition than we give ourselves credit for. There are things we can do to make a difference, like cutting back on processed food, drinking enough water to stay hydrated, getting good sleep, exercising regularly, and managing the stress in our lives as much as we can.
“Migraine can be managed, and a high quality of life is achievable.”
For a questionnaire to help your doctor treat your migraine, scroll to the bottom of this page on the Migraine and Headache Australia website.
© 2024 Jean Hailes Foundation. All rights reserved. This publication may not be reproduced in whole or in part by any means without written permission of the copyright owner. Contact: licensing@jeanhailes.org.au
Words by Muriel Reddy. Illustrations by Tam Bower.
Published September 2024
This article is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.
Jean Hailes for Women’s Health gratefully acknowledges the support of the Australian Government.
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