Not tonight, I have a headache

Women suffer from migraines nearly twice as often as men

The gender divide can run wide when it comes to many things. But no one warned us about migraines. Unfortunately it’s true: Women are more prone to migraine headaches than men.

The comparison is staggering when you look at statics: 18 percent of women suffer from migraines compared with just 6 percent of men. And by age 50, up to 40 percent of women have been affected by migraines.

“The easy answer is hormones, but the reality is that it is a combination of many things,” said Brian Plato, D.O., neurologist and headache specialist with Norton Neuroscience Institute’s Headache & Concussion Center. “The most commonly identified triggers for migraine are hormonal changes, sleep changes, stress and dietary changes. You can see how these triggers frequently affect women.”

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About 60 percent of women report their migraines worsen during menstruation, when a drop in estrogen occurs. These migraines are referred to as either pure menstrual migraine (PMM) or menstrually related migraine (MRM).

“These definitions have to do with the frequency of migraine not related to menstruation,” Dr. Plato said. “PMM is migraine that occurs only with menstruation, and MRM is more frequent and severe migraine with menstruation, but migraine at other times of the month as well.”

Other migraine triggers include:

  • Weather changes
  • Skipped meals
  • Alcohol consumption
  • Eating foods that contain preservatives such as MSG and nitrates
  • Eating tyramine-rich foods (aged cheeses and cured or smoked meats)

Luckily, changing your diet can eliminate these migraine triggers. Preventive and rescue strategies can help with hormone-related migraines.

The most common preventive treatments, according to Dr. Plato, include medications (prescribed and over-the-counter), stress management, sleep training, physical therapy and exercise.

Rescue treatments largely include medications. If prescribed medications are needed, they should not be used more often than twice per week.

“If rescue medications are needed more frequently, it’s time to talk to a physician about better preventive strategies,” Dr. Plato said.

Along with medication overuse, the most common migraine mistake Dr. Plato sees is a downplaying of symptoms.

“My rule of thumb is that when a patient is uncomfortable with headaches, she should seek medical attention — whether it is a single headache that seems unusual or multiple headaches that are occurring more frequently than the patient is comfortable with,” he said. “And it is important to remember that there is no such thing as ‘my normal everyday headache.’ It is not normal to have a headache every day.”

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