Women most often are the victims of migraine headaches
According to the National Headache Foundation (NHF), 28 million Americans suffer from migraine headaches each year. Of those 28 million, 19.6 million are women. That accounts for 70 percent.
Given that one in four families are affected by migraine, chances are you know someone who experiences these throbbing headaches.
What makes migraines different from other types of headaches are the accompanying symptoms: nausea or vomiting, sensitivity to light, sound and head movement and sometimes visual disturbances, referred to as an “aura” (bright flashing lights or stars, blurred vision, spots, zig-zaggy vision, etc.)
Migraines most often occur between the age of 30 and 50, and in women, may have a hormonal association. Some doctors note that menopause frequently ushers in the end of migraines.
What are the triggers of a migraine? While they vary from patient to patient, triggers often include stress, poor sleep habits, hormonal changes, hormonal medications (birth control pills, hormone replacement), certain odors like perfume, skipped meals, flickering lights, changes in weather and certain foods. Some foods that can trigger migraines include aged cheese, chocolate, red wine, preservatives like nitrates and sulfites and the flavor enhancer MSG.
Migraines may be hereditary. If both patients have migraines, there’s a 75 percent change the children will also have them.
Migraines may last from several hours to an incapacitating several days. The NHF estimates that $50 billion is lost in the workforce each year due to absenteeism and medical expenses caused by headache.
A recent survey taken by the NFH indicated women who experience migraine suffer an average of five headaches per month, nearly 90 percent of them experience them at work, and nearly half report that their ability to function at work or home is affected by their headaches.
In addition, the American Headache Society reports that, in women who suffer migraine, the severity, disability and frequency often varies with the phase of menstrual cycle. Some 60 percent of suffers report an increase in migraine prior to their periods. This is often referred to as “menstrual migraine,” though it lacks a unified definition.
Migraines may also worsen just prior to menopause.
What can bring relief?
Most experts agree that accurate headache diagnosis and treatment is essential. A complete exam should include a series of questions designed to help your doctor determine if your headaches are truly migraine. Once diagnosed, treatment may include medications along with changes in lifestyle and avoidance of triggers.
Today’s medications for migraine include drugs that were originally formulated for other disorders but found to be equally helpful for migraine, such as beta blockers (metoprolol or lopressor, nadalol, atenolo, propranolo and timolol), calcium channel blockers (specifically verapamil) MAO inhibitors, tricyclic antidepressants (amitriptyline, protriptyline, nortriptyline, imipramine, desipramine and doxepin) and Prozac.
Recent medications designed specifically to abort migraines include a group commonly known as “triptans.” The first of this class includes sumatriptan, with the brand name Imitrex. The injectable form can relieve migraines in as little as 15 minutes. Imitrex is also available in tablet or nasal spray. But this is a powerful drug and needs to be used with caution and under a doctor’s care.
Other triptans include Amerge, Exert, Frova, Maxalt and Zomig.
Another class of abortive drugs are the ergot based, such as Cafergot, Ergomar and Wigraine. Ask your doctor of pharmacist about these medications.
Prophylactic medications designed to prevent symptoms and approved by the FDA for migraines are Depakote, Inderal, Blocadren and Sansert. Depakote, an anti-seizure medication, suppresses the impulses that set off the brain’s pain generator.
A recent student at a headache clinic in Chicago used injections of botox in various locations on the head as a means of preventing migraines. More study needs to be done, but researches say the results are not promising.
In mild cases, simple over-the-counter pain medication can be used successfully, such as ibuprofen, Tylenol or aspirin.
Lifestyle changes that improve the outcome for migraine sufferers include a balanced diet, adequate sleep, daily exercise and, in the opinion of some, the avoidance of sugar.
While we’re on the subject of diet, researchers in Brooklyn, N.Y., found a possible link between menstrual migraines and magnesium deficiency. While no recommendation was made to incorporate more magnesium into the diet, magnesium supplementation may be helpful for some migraine sufferers, particularly during the menstrual cycle. Ask your doctor of a nutritionist for some guidelines.
Finally, the NHF suggests you be a self-advocate. Seek help and educate yourself. Know how and what to communicate to your doctor. Keep a detailed headache diary, focus on solutions, be positive and have reasonable expectations about treatment. If not satisfied with your current doctor, search for a physician who is knowledgeable about treating headaches and partner with him/her for success.
Jan Hawkins is a freelance health-care journalist residing in northern Kentucky.