Women and migraines: Understanding the impact, triggers, and treatment
Equity in healthcare series – part 3
Introduction
Migraines are a debilitating neurological condition that disproportionately affects women. These recurring headaches cause severe throbbing pain, often localized to one side of the head, and can be accompanied by mood changes, fatigue, nausea, vomiting, and sensitivity to light, noise, and smells. According to the American Migraine Foundation, migraines are the second leading cause of disability globally.
The gender gap in migraines
Women are three to four times more likely to experience migraines than men. Research suggests that estrogen plays a significant role in migraine development, making women more susceptible during their reproductive years. This hormonal connection underscores the need for gender-specific research and treatment approaches in migraine care.
Common migraine triggers
Migraines can be triggered by a variety of factors, including:
- Genetics
- Stress
- Hormonal changes in women
- Sleep variations
- Caffeine use or withdrawal
- Weather changes
- Certain foods or ingredients
The four phases of a migraine
Migraines progress through four distinct phases:
- Prodrome: Occurs a day before the migraine, with symptoms like mood changes and food cravings.
- Aura: Involves visual disturbances such as flashing lights or blind spots.
- Headache: The main phase characterized by intense pain, often lasting hours to days.
- Postdrome: The recovery phase, where individuals may feel drained or weak.
Managing symptoms and reducing frequency
While there is no cure for migraines, treatments focus on alleviating symptoms and preventing future episodes. Two primary approaches exist:
- Preventive treatment: Reduces the frequency and severity of migraines.
- Acute treatment: Aims to stop a migraine once it starts.
Medication for migraines
A recent study evaluated the effectiveness of ibuprofen compared to other migraine treatments. The findings revealed that triptans are five to six times more effective than ibuprofen. Triptans work by altering blood circulation in the brain and modifying pain signal processing. Other notable medications include:
- Anti-emetics: Help relieve nausea and vomiting associated with migraines.
- Ergots: Cause blood vessels to constrict, reducing migraine severity.
Innovative treatments
Beyond traditional medications, newer treatments are offering relief to chronic migraine sufferers:
- Anti-CGRPs: A newer class of drugs that prevent blood vessel expansion, available in oral, intravenous, or injectable forms.
- Botox: Blocks neurotransmitters that transmit pain signals to the brain. Typically administered every three months, Botox can reduce the frequency of migraines.
Conclusion
As research continues, a deeper understanding of migraines in women is crucial. With advancing treatments and increasing awareness, more women can find effective strategies to manage their migraines and improve their quality of life.
For more information on migraines, visit the American Migraine Foundation.
This is part three of a series about disparities and a call for equity in healthcare. In future installments, we will explore inequities in treatment access across other high risk diseases, the impact of socioeconomic factors, and emerging advocacy efforts aimed at closing these healthcare gaps.
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References
- Migraine. National Institute of Neurological Disorders and Stroke: https://www.ninds.nih.gov/health-information/disorders/migraine#:~:text=A%20headache%20during%20a%20migraine,nausea%2C%20vomiting%2C%20or%20constipation.
- Rossi, Maria Francesca. Tumminello, Antonio. Marconi, Matteo. Gualano, Maria Rosaria. Santoro, Paolo Emilio. Malorni, Walter. Moscato, Umberto. Sex and gender differences in migraine: a narrative review. Neurological Sciences. June 2023: https://pmc.ncbi.nlm.nih.gov/articles/PMC9176156/#:~:text=Migraines%20are%20among%20these.,in%20woman%20than%20in%20men.
- Migraine. Medlineplus: https://medlineplus.gov/migraine.html
- Chawla, Jasvinder. Migraine Headache Treatment & Management. Medscape. August 26, 2024: https://emedicine.medscape.com/article/1142556-treatment
- Corliss, Julie. Which migraine medications are most helpful? Harvard Medical School. February 5, 2024: https://www.health.harvard.edu/blog/which-migraine-medications-are-most-helpful-202402053014
- Triptans. Cleveland Clinic: https://my.clevelandclinic.org/health/treatments/24998-triptans
- Ergot- Uses, Side Effects, and More. WebMD: https://www.webmd.com/vitamins/ai/ingredientmono-431/ergot
- Cafasso, Jacquelyn. Antiemetic drugs. Healthline. January 28, 2024: https://www.healthline.com/health/antiemetic-drugs-list
- Felman, Adam. Calcitonin gene-related peptide (CGRP): Uses and side effects. MedicalNewsToday. September 26, 2023: https://www.medicalnewstoday.com/articles/calcitonin-gene-related-peptides
- Bernstein, Susan. Botox Injections for Migraine Treatment. WebMD. April 25, 2024: https://www.webmd.com/migraines-headaches/botox-migraines
- Weiss, Cynthia. Mayo Clinic Q and A: Botox for migraines. Mayo Clinic News Network. September 18, 2022: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-botox-for-migraines/
- American Migraine Foundation homepage: https://americanmigrainefoundation.org/
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