Imagine you're at work and have an important deadline to meet, only to be halted by a headache so severe that you can't go on. It's pretty normal for people to experience headaches in one form or another, but less frequently migraines that are debilitating. What people don't realise is that if you're experiencing frequent headaches, you could be living with chronic migraine.
1.5 Million women in Australia suffer from migraine, compared with 500,000 men. If you're one of those people, you know how exhausting and frustrating a migraine can be. There may be days where you can't accomplish anything because you can't see straight. Or times when you have had to escape to a dark quiet room to avoid tasks, lay down or even sleep.
Question: What is the difference between a typical headache and a migraine?
Dr Bronwyn Jenkins: A typical headache is pain or discomfort felt in the head region (face, scalp, behind the eyes, etc). Migraine, on the other hand, is "not just a headache". The pain of a migraine can be moderate to severe intensity pain, throbbing or pulsating and typically on one side of the head. In addition to the pain, there can be accompanying feelings of nausea and/or vomiting and/or sensitivity to light and/or sound. These migraine headaches, compared to a typical headache, often get worse by physical activity. A migraine can last between four hours to three days untreated. Not all migraines will have all of the features but if there a few associated features, then it is most likely migraine rather than just a typical headache.
Question: What characterises chronic migraines + symptoms associated with chronic migraine?
Dr Bronwyn Jenkins: The criteria below are used to diagnose chronic migraines:
• 15 or more days of headaches each month including
• eight or more days of headaches that have features of migraines each month
• Occurring for three or more months
Question: How are chronic migraines diagnosed?
Dr Bronwyn Jenkins: Currently, there's no formal test for diagnosing migraines. However, a doctor will make a diagnosis from two sources: detailed patient history of headaches and interpreting patient symptoms. Materials like headache diaries can also help the patient and doctor understand the pattern of headaches, what their triggers may be and what assists in minimising migraines. It is important to recognise and diarise the less specific lower grade headaches, as well as the more significant migraine attacks, on the diary.
Question: Why do more women suffer from migraines than men?
Dr Bronwyn Jenkins: Women experience migraines more than men, usually by a factor of 2:1. It is more prevalent in women compared to men, as a result of hormonal fluctuations such as oestrogen. That said, not all migraines are strictly hormonally-caused.
Question: Is it possible to treat or prevent a chronic migraine?
Dr Bronwyn Jenkins: Currently, the specific cause of migraines is unknown. Scientists believe there is a complex interaction of genetics, environmental factors, and brain chemical composition (neurotransmitters) playing a role. Lifestyle modifications such as healthy diet, avoiding dietary triggers (such as caffeine excess), regular exercise between attacks, regular sleep, stress management strategies and avoiding other triggers such as bright lights, chemical smells and loud noise can help sometimes. In addition, there are medications that can be taken for acute attacks, such as triptans or for prevention of attacks, such as regular oral or injectable treatments.
Question: What advice do you have for women who suffer from migraines?
Dr Bronwyn Jenkins: The advice for women is to consider what factors are most relevant to you in your lifestyle and to seek out the most effective the management strategies for attacks. If the migraine attacks are frequent, there are many strategies to reduce the migraines. Overall, the advice is usually similar to others with migraine. If the migraines are mainly related to the timing of the menstrual periods, then some women can have hormonal therapy to decrease the number of periods each year and to choose the timing of the worst menstrual migraines. However, some women aren't suitable for such hormonal therapies due to other individual factors so it is necessary to discuss this and the other management strategies with the medical practitioner to determine which treatment option is best.
To find out more information about migraines, there are useful organisations and websites, including Headache Australia, the Australia and New Zealand Headache Society and www.chronicmigrainehelp.com.au. These resources can give you more details about migraine, with useful materials for you and your doctor. Migraine matters so don't ignore it and improve your quality of life by managing it well.
Interview by Brooke Hunter
Photo by Anh Nguyen on Unsplash