Migraines are a real disease: Facts, prevention, and treatment
By Anastasia Dimitropoulou
Some Migraine Facts
1 in 7 people suffer from migraines, which translates to over 1 billion people globally or nearly 15 percent of the world population!
The World Health Organization notes that migraines are 3 times more common in women than in men. Τhey are the second cause of a neurological disability (the first is epilepsy) and the sixth most debilitat-ing condition globally in terms of years lost to disability – and in people under 50 it ranks third. Even though migraines do not shorten people’s lives, they do greatly affect work and family life in terms of ability to function during attacks and lost work days.
These are some of the facts presented during the WBP’s International Forum on Women’s Brain and Mental Health in June 2019 in a panel dedicated to migraine and sponsored by Eli Lilly. Featuring our Chief Scientific Officer, Maria Teresa Ferretti, alongside other prominent experts in the field such as Laura Campo, Patricia Pozo Rosich, Elena Ruiz de la Torre and Joke Jaarsma, the discussion aligned around the importance of recognizing migraine as a disease and not only as a “strong headache.”
This debilitating disease manifests predominantly with disabling attacks. As mentioned, a woman between 18-64 years old is three times as likely as a man to get a migraine, and tends to report more disability in relation to attacks. This difference is often hormonally-driven and there is current evidence that sex differences exist in protein levels of two key components which play an important role in migraine pathophysiology. Migraines need to be properly diagnosed and treated. Access, research, innovation and education are the pillars of improving patient care also in migraine.
If not a “strong headache,” what are migraines?
Migraines are a neurovascular disorder creating a neurosensorial disease, involving nerve pathways and brain chemicals, causing throbbing pain. The brain itself feels no pain, but the cranial structures like the skin, muscles eyes, ears, sinuses, and dural arteries do.
The most obvious difference between a headache and a migraine is the intensity and duration. It is not exactly known what causes migraines, but it appears that genetics, environmental factors, lifestyle, brain chemical imbalances are still all being researched. Migraines may also be caused by changes in the brainstem and the trigeminal nerve (a major pain pathway), your family history, and/or if you are female. After the active migraine attack, symptoms can last 24-48 hours for most people (e.g., a bit of dizziness, confusion, sensitivity to light and sound, or digestive issues).
A recent study emphasizes that migraine can be a risk factor for dementia in women. Migraines are associated with chronic pain, and chronic pain substantially impacts the risk of memory decline and dementia.
Video of the Migraine Panel from the WBP Forum 2019, courtesy of Eli Lilly
What are the symptoms of a migraine?
Migraines can be experienced differently by each individual. Some of the most reported and common symptoms are nausea, neck pain or stiffness, frequent yawning, sensitivity to light, smells and sounds, constipation, food cravings, mood swings, increased thirst and urination, vomiting, and “auras”. Auras can range from visual, sensory (hearing noises, or noise sensitivity), flashing lights, and zigzag patterns.
For more about different types of migraine, click here.
How can someone know if they have a migraine? The International Headache Society explains that the headache has 2 out of the 4 following pain characteristics:
- one-sided pain;
- moderate to severe pain intensity; and
- pain that worsens with activity, like walking stairs or climbing stairs
The diagnosis is made after a person has experienced at least 5 attacks per month that last between 4 hours and 3 days, and at least 1 additional symptom, most often nausea, vomiting, sensitivity to light, or sensitivity to sound.
The severe pain of a migraine can stand in the way of living a productive life.
How can you treat a migraine?
The key is to treat the symptoms, mainly the headache, as early as possible – within 15-30 minutes of the onset of pain.
Prescription treatments exist that can eliminate a migraine attack; however, some of the new medicines being approved are not reimbursed in certain countries because they are considered too expensive; hence they are not always accessible to those who need them. Hydration can also help overall.
Those who are experiencing frequent migraines should speak to their doctor, neurologist, or functional medicine doctor on how to correctly treat their migraines. Currently, physicians also emphasize habit and lifestyle changes to help to prevent and treat migraines.
Here are some tips on hormone levels, nutrition, exercise, meditation, and sleep:
Check your hormones
Changes in hormonal levels can trigger migraines. This is especially true for women based on their menstrual cycles. Often, it can happen between two days before and three days after their periods. Other vulnerable times in a woman’s life are the peri-menopausal and menopausal. However, when menopause is over, the frequency and strength of migraines will often decrease.
For some women, making dietary and lifestyle changes are enough to balance hormones. Starting a headache journal to track your cycle is a way to identify whether hormone imbalance is the root cause. Talking to your doctor is important to measure any hormonal imbalances and define your action plan.
Focus on your nutrition
People who suffer from migraines have to be very careful with what they eat. Certain foods and drinks tend to be triggers, though there is no single list of what foods to avoid.
Alcohol and dairy products may trigger migraines. Generally, the more processed the food, the bigger a trigger it can be.
Other items, such as caffeine, still require research to better understand their role in relation to migraines and whether it is a trigger or alleviates symptoms. It is likely that caffeine generates a very individual type of response, emphasizing once again the importance of personalized medicine.
The best way to understand and define which foods could trigger your migraines is to consult your doctor and follow what is called an “elimination diet”.
A regular exercise routine, including cardio such as running, swimming, cardio classes or something less physical, such as yoga, walking, or pilates, is also another way to manage your migraines.
Getting physically active – and you can get creative to find ways to integrate physical exercise into your daily habits – will contribute to reduced stress levels, and increase your oxygen intake. All the released endorphins, the “happy hormones”, will make you feel much better and can potentially help you manage your migraines.
Stress and other emotions, such as anxiety and tension, can trigger migraines. Introducing a practice such as meditation can reduce the nervous system tension and response to internal or external stimuli as well as improve oxygen delivery everywhere, including the brain. There are many online applications that can help you go through 5-10 min meditation sessions to get started. Meditating is a great way to reduce stress and potentially your migraines.
Prioritize your sleep
Because of our busy lives, a lot of us don’t pay as much attention as we should to sleep. Quality sleep can fix a lot of our health issues, including migraines. Getting the same number of hours of sleep each night is important, but just as important is that those hours are on the same schedule.
You can improve the quality of your sleep by:
- going to bed at the same time every night,
- eating a light dinner at least two hours before bed-time,
- introducing some meditation to your sleep routine,
- removing all electronic devices and any light sources from your bedroom, and
- sleeping for 8 hours each night.
The bottom line is that you should try to be smart about your health. We are empowered to take care of ourselves. If you – or someone you know – suffer from a headache that’s incredibly intense, lasts longer than a day, is very severe and sudden, go see a doctor.
The Women’s Brain Project is dedicated to increase the awareness of sex and gender differences of women’s brains and the need for specific research and treatments through precision medicine. Migraines are not just an “intense headache;” they are still highly stigmatized, under-diagnosed, under-recognized, under-treated, and the lack of respect for their importance is still there. It is past time to take migraines seriously and treat them with the respect they deserve.
Featured image courtesy of Pixabay.