The prevalence of migraines is two to three times higher in women than in men. The character of the headaches also differs between the sexes. Women tend to report higher levels of pain, longer duration of headaches, and more associated symptoms, such as nausea and vomiting, though visual symptoms are less common in women.
There is a long-recognized association between ovarian hormones and migraines. Over half the women who experience migraines report an association between their headaches and their menstrual cycle. The frequency and severity of migraines are often increased with the use of oral contraceptive pills and during menopause.
Because migraines are affected by hormonal fluctuations, estrogen use during the premenstrual period is sometimes helpful. However, ironically, estrogen may also trigger migraines. Women should discuss with their physician or clinician the use of estrogen, such as through oral contraceptives and hormonal therapy, for migraines.
Stress often triggers migraines, so women who are habitual sufferers should learn relaxation and stress management techniques. These are especially helpful in aborting headaches when warning signs are felt. Massage and relaxation exercises of the neck, shoulder, and jaw muscles may all be helpful. Resting in a dark room with cool compresses can prevent the headache. Foods such as alcohol, aged cheeses, chocolate, fermented or marinated foods, MSG, artificial sweeteners such as aspartame, and caffeine all may trigger headaches; diet should be monitored to reduce or eliminate intake of these. Nicotine may cause migraines as well. If you’re a smoker, consider quitting to reduce migraines.
In summary, each woman’s migraine pain, her triggers, and her “headache calendar” (when headaches tend to occur) are unique. Treatments are also unique for each case. To properly plan treatment, individual triggers, lifestyle issues, stress levels, eating habits, and willingness to accept drug therapy must be considered.
Women with moderate migraines may need prescription drugs for relief. These could include agents that affect neurotransmitters (the chemicals that are the messengers in the brain), such as sumatriptan and various antidepressants. Other drugs might include agents that dilate (widen) the blood vessels in the brain. In some cases, painkillers are prescribed.
If you experience any of these symptoms, talk to your Women’s Health Connecticut OB/GYN today.