Many women know just how debilitating a migraine attack can be. Aside from the pain, they make functioning in our day to day lives feel close to impossible. And did you know women are much more susceptible to this delightful type of headache?
According to Dr. Jared Pomeroy, a neurologist specializing in headache neurology at Corewell Health, depending on the study, rates of migraine in women are three to four times more prevalent than in men. He also shared that migraine affects up to 12% of the general population, with the prevalence of migraine typically peaking in those in their 30's and affecting about 24% of women.
So why is this? Dr. Pomeroy explains how hormones play a complex role in migraine attacks.
"We frequently see migraine flare up just before or during the menstruation phase of the menstrual cycle," Dr. Pomeroy said, noting this coincides with a decrease in estrogen levels. "We think the rate of decrease of estrogen levels is likely important in the triggering of menstrual-related migraine. We also frequently see migraine triggered after pregnancy and similarly relate this to changing hormones. Interestingly, about two-thirds to three-quarters of women find that pregnancy is often a time of relatively few migraine attacks."
There are some distinguishing factors for determining if what you're experiencing is a migraine attack.
"The most common misdiagnosis is tension type of headache," Dr. Pomeroy shared. "If a moderate level headache or worse is accompanied by light and/or sound sensitivity or nausea and/or food avoidance, then it's probably a migraine. Tension type headaches do not have these associated symptoms. That being said, people without an established migraine diagnosis or those with new symptoms should discuss with their doctor to be sure there's not a need for additional evaluation."
Common lifestyle triggers for migraine include stressors, disrupted sleep, poor diet and skipped meals—all of which Dr. Pomeroy recommends addressing, as they can help minimize the need for migraine medications.
Relief and treatment options for women suffering from migraine attacks can come in a number of forms.
"Pharmacologically, we use a lot of new anti-calcitonin gene-related peptide therapy and a lot of injectable Onabotulinum toxin A (also known as Botox) for chronic migraine," Dr. Pomeroy said, noting that most people with more than four to six migraine days per month can really benefit from preventive therapy. "However, even with good preventive therapy, a comprehensive treatment plan needs to have medications available for people when they do have breakthrough attacks."
Non-medical options for relief also exist.
"We recommend yoga to many of our patients—it can really be worked into a patient's lifestyle," Dr. Pomeroy said. "The stretching and strengthening nature of yoga can help quite a bit. The breathing in yoga is also a great way to learn some principles of biofeedback-type therapy."
Reducing the frequency of migraine attacks is certainly the goal for anyone who experiences them, and Dr. Pomeroy shared some suggestions for working in that direction.
"I think the biggest key is focusing on lifestyle factors to minimize those triggers that can be minimized, and to seek help," he said. "If migraine is impacting you, you really should discuss it with your physician. Headache disorders are the second leading cause of years of life lived with disability and are frequently undertreated in the healthcare setting."
Beyond treatment, it can be difficult for women to navigate migraine symptoms and attacks when they've got several responsibilities to juggle, including jobs and caring for other family members. It can take an emotional toll, along with carrying a stigma.
"We have many patients who need support. Chronic pain wears on patients, and the value of working with a good pain psychologist cannot be stressed enough," Dr. Pomeroy said. "There's a lot of stigma that comes with migraine because it's disabling but often not recognized or appreciated by many people. I think actively communicating about migraine with those around you can be very beneficial and helpful in spreading awareness."
Written by Sarah Suydam, Managing Editor for West Michigan Woman.
This article originally appeared in the Dec '24/Jan '25 issue of West Michigan Woman.
