Why Vimhans Nayati suggests that women are more vulnerable to migraine

By Dr. Namita Kaul, Consultant Neurology, Vimhans Nayati Super Speciality Hospital, New Delhi

Headache is one of the most common medical problems. At least 50% of the population suffers from headache at least once in their lifetime.

Headache becomes a problem when it gets recurrent, and then it should be evaluated. One should understand headaches could be of two types- first, the primary headache that is disabling but not worrisome or dangerous. Then is the secondary headache, which could be due to tumor, brain infection, low or high blood sugar and there is a long list of that.

There are certain signs and symptoms of secondary headaches that people can recognize and immediately consult a neurologist. Some common symptoms are a sudden severe headache, a headache that wakes you up in the sleep or if a headache is associated to vomiting.

Migraine, tension type headache or cluster headache comes under Primary Headache. Doctors at Vimhans Nayati Super Specialty Hospital express that these primary headaches are associated with disturbance in the pain system of the brain that leads to a triggering of the pain circuit.

According to the search women are three times more likely to get migraines than men. Women experience migraines that are longer and more painful whereas male users seemed to average at six migraines a month. 18% of women suffer compared to 6% of men. But during the reproductive years, as many as 37% of women suffer.  Of those who suffer, 50% have more than 1 attack each month, and 25% have 4 or more severe attacks per month. 85% of chronic migraine sufferers are women. 92% of women with severe migraine are disabled.

Experts at Vimhans Nayati state that hormones have an impact on migraine in women. Many women find their migraine symptoms are affected by menstruation, hormonal contraception, pregnancy, and menopause.

Menstrual migraine is an attack that occurs up to two days before and up to three days after your period begins. It’s usually more severe and more difficult to treat than other types of migraine. 7-19% of women get menstrual migraine. Hormonal fluctuations, and especially estrogen withdrawal, are thought to trigger the attack.

Hormonal contraception, like birth control pills can have impact on migraine, varying from woman to woman. These oral contraceptives can trigger a woman’s first migraine attack. They should be consumed after weighing the risks and benefits of a particular contraceptive with their doctor, especially if there is a family history of migraine.

Pregnancy and migraine have erratic relationship. 60% of pregnant sufferers find their migraine improve significantly in their first trimester, and more than 75% find they improve or even disappear during the rest of their pregnancy. Unfortunately, this is not the case for everyone. 15% report their migraines worsen during the first trimester, and about 25% notice no change. Migraine sufferers should discuss their pregnancy plans with their doctors. Some migraine medications may impact the ability to conceive and may harm the fetus.

Migraines often worsen during perimenopause, the years before menopause, with intense hormonal fluctuations. Women who go through natural menopause often find their migraine symptoms improve dramatically, while women who experience a surgical menopause often suffer more. The effect of estrogen replacement therapy on migraine varies.

Considering the above factors, women should take care of their health, their lifestyle to control headaches. If headaches are frequent, troublesome then it is a cause of worry and they should be medically consulted. Never take more than 4 painkillers in a month and if that is the case then a more appropriate anti migraine therapy is recommended.

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