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Why Women Get Migraines More Than Men

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Artwork by Anna Jay, Photograph by Eric T White.
Migraines: “Usually a severe headache felt as a throbbing pain at the front or side of the head”, according to the NHS online. For me, the experience feels more like a hammer slowly pounding at every synapse in my brain for hours on end.

I first experienced a migraine when I was 18 and in my final year of school. I woke up one morning with the sensation that my brain had grown a layer of cling film over it. I walked around for a week confused and dizzy, convinced that I was experiencing some kind of stress-induced psychosis.

It was only when I was finally taken to a neurologist that I was diagnosed; I suffer from ‘migraines with aura’. This ‘aura’, is unfortunately not a luminous glow around my person, but rather a word used to describe the symptoms which often precede a migraine. These can range from slight dizziness to extreme nausea to light sensitivity (medically known as photophobia). For some, however, experiencing an aura can seriously affect their vision, cause paralysis and speech difficulties.

Research shows that migraines are more common in women than men. The NHS estimates that one in five women in the UK suffer from migraines, compared to one in every 15 men. Statistics released by the Migraine Research Foundation revealed that of more than 38 million American sufferers, 28 million were women. This obviously prompts the question: Why?

Dr. Nazeli Manukyan is a headache specialist at the National Migraine Centre. She explains that it is a “well known fact” women suffer from migraines more than men. She adds, “Women have migraines three times more frequently than men. The underlying reason is most likely hormones and genetic predisposition.”

The exact cause of migraines is as yet unknown, although there is a strong link to the menstrual cycle. The Migraine Research Foundation notes that girls are more likely to experience their first migraine in the year they get their period than at any other time in their lives. The cause of this may be levels of oestrogen, one of the two main sex hormones found in women.

The Mayo Clinic suggests that “the hormones oestrogen and progesterone play key roles in regulating the menstrual cycle and pregnancy and may also affect headache related chemicals in the brain.” Thus, the hormones intrinsic to periods and pregnancy may also be at the root of women’s migraines too.

women of childbearing age seem more affected

Dr. Manukyan backs this up, adding “hormonal changes throughout menstrual cycle, pregnancy, lactation and later peri-menopause are well known triggers for migraine without aura. So women of childbearing age seem more affected.”

Indeed, many women who experience migraines seem to relate it to their periods. Emily, 24, who has suffered from severe migraines for five years, says that, “they usually follow the moon or my period once a month.”

She adds that, “When I start forgetting words, names or being able to read sentences I know that the inevitable is due in an hour and my only salvation will be a dark room, painkillers and the ‘Call Your Girlfriend’ podcast, which I put on to remind myself that there is a world which exists beyond my migraine.”

Harriet, now 23, has had them since she was 18 and cites the pill as a factor in their increase. She says, “I get them regularly, maybe once a fortnight, but being on a progestogen-only pill made them extremely frequent.”

Women with migraine with auras are advised not to take the combined oral contraceptive pill due to the small risk of strokes; but the progestogen-only pill (a pill without oestrogen) can in turn lead to further headaches.

Most experts draw a connection between the menstrual cycle and migraines. However, research undertaken at UCLA in 2007, suggested the possibility that women may have a faster trigger than men for activating the waves of brain activity thought to underlie migraines. A study carried out by the department of neurology revealed that it was easier to evoke the waves of brain activity which underlie migraines in female mice, and that this trigger was independent of the menstrual cycle. However this remains largely unconfirmed and wider study and further research is needed to verify the department’s findings.
There is no cure for migraines, but the NHS suggests that attempting sleep (if possible) or lying down in a dark room can help. Over-the-counter painkillers such as paracetamol or ibuprofen can also help. In severe cases, GP’s may recommend triptans, which are painkillers that cause the blood vessels around the brain to contract. These vessels are thought to be part of the migraine process, and thus this can alleviate some of the pain.

As with everything migraine related, trying to understand them can in turn give you a headache. There are many reasons why women suffer more than men, but there is no one definitive cause. Plus, if as Dr. Manukyan asserts, the cause may be hereditary – “there is also a strong genetic link as cases of migraines in female family members is more common” – then there is little we can do to prevent them.

This is the demographic I fit into, hailing from a long line of female-migraine sufferers. So for me it’s just another thing I’ll blame on my mother and my period; but there is still research being done into migraines, sparking hope that at some point in the future we may be able to better understand why so many women suffer from them.
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