Why Women Get More Migraines, and 10 Possible Solutions
The Migraine Research Foundation (MRF) states that nearly one in four households includes someone who suffers from migraines. Over 12 percent of the American population has them—more than diabetes and asthma combined.
Women get them more often. According to a 2009 survey by the Centers for Disease Control and Prevention (CDC), about 21.8 percent of women suffer from them, versus 10 percent of men. The MRF estimates it at 18 percent of women and 6 percent of men.
As anyone who’s suffered a migraine will tell you, these aren’t normal headaches. They are debilitating. A World Health Organization 2001 report stated that among all adults, migraine is one of the top 20 causes of disability, with severe migraines considered among the most disabling illnesses, comparable to dementia, quadriplegia and active psychosis.
One of the most frustrating things about migraines is their resistance to treatment. Ask a woman who’s had them for years and you’ll likely hear a story of numerous solutions tried, from medications to avoidance of triggers to massage and meditation to herbs and supplements. Some things will help and some won’t, and often it depends on a number of factors that can be difficult to control.
Fortunately, we’re learning more about migraines every day, and we have some new treatments available now that weren’t out there only a few years ago.
What is a Migraine?
A migraine is a type of intense headache that is often accompanied by other symptoms, including the following:
- sensitivity to light, sound, and smells;
- nausea and vomiting;
- vision disturbances;
- and a throbbing or pulsing sensation.
The pain also tends to be moderate to severe.
Whereas you can have pain and dizziness with other types of headaches, and possibly other symptoms like congestion or facial pressure, migraines tend to be more intense, and often affect only one side of the head (though they can affect both). The pain will be bad enough that it will be difficult to continue going about normal daily activities.
A subsection of the population who has migraines will also experience a symptom called “aura,” which refers to the odd sensation that can occur before the full onslaught of the headache. The victim may experience visual disturbances, tingling or numbness in the face and hands, and difficulty concentrating.
Most doctors see migraine as a type of “syndrome” or collection of symptoms all related to the same cause, rather than just a headache. Migraines also tend to be recurring, attacking in response to certain “triggers” sufferers may experience. These may include:
- a bad night’s sleep,
- hormonal changes (key trigger for women),
- certain foods and food additives,
- weather changes,
- bright lights and loud sounds,
- and some medications (like birth control pills and vasodilators).
Why Are Women More Vulnerable to Migraines?
Scientists have been looking into this for years, and they have come up with some answers. Here are a few of them.
- Hormonal Fluctuations: Scientists now know that changes in hormones can trigger migraines, which naturally increases women’s risk because of the monthly menstrual period. A 2012 study, for instance, reported that migraines usually start after a girl first experiences her period, and then often recurs in the days before menstruation, while tapering off during pregnancy and after menopause.
- Different Brain Patterns: Some research shows that women have certain brain connections that are different from those in men that make them more susceptible to migraine pain. In a 2012 study, for instance, researchers found through MRI scans that women who suffered from migraines had thicker gray matter in two areas of the brain compared to men and women without migraines. “Studies like this take migraines out of the realm of the subjective and show fundamental changes responsible for these differences,” said Andrew Charles, neurologist at the University of California, Los Angeles. “It’s quite validating for people with migraines who understand something quite significant is happening in their heads.”
- Enhanced Sensitivity to CSD: Cortical spreading depression (CSD) is a term used to describe when the cortical neurons in the brain go quiet. It’s described as a type of wave or ripple in the brain when the normal flow of electric currents is somehow reversed. There has been some research that when this happens, it can cause the “aura” some patients experience before migraine, and may be related to the cause of migraines themselves. Women are thought to be more sensitive to CSD than men. This area of research is so promising that new drugs that block CSD are being tested for their potential effectiveness against migraines.
- Childhood Neglect & Abuse: An interesting avenue of study on migraines has looked into a certain group of people—those who experienced emotional abuse or neglect as children. A 2015 study reported that rates of so-called adverse childhood experiences were significantly higher in participants with migraines. More specifically, rates were about 24.5 percent for emotional neglect, 22.5 percent for emotional abuse, ad 17.7 percent for sexual abuse—all higher than rates in those who didn’t experience migraines. A second study in 2015 found similar results—the more types of violence children were exposed to, the higher their risk of migraines. Statistics show that more girls suffer abuse than boys, which may relate to the number of women experiencing migraines.
10 Treatments that May Help
Whatever may be causing your migraines, you’re probably most concerned with finding relief. According to the Mayo Clinic, migraines can’t be cured. Our best hope so far is finding a way to manage them, reduce their occurrence, and reduce the intensity of the pain when we do have them.
Fortunately, there are several potential treatments out there that can help. It may help to realize that no one treatment fits all, and that sometimes, what works for a while may not work after a few years. The key is to be open to trying other potential solutions when needed.
- to avoid triggers: It’s not always possible, but the more you avoid your triggers, the fewer headaches you’ll have. Try to get a good night’s sleep on most nights, eat regular meals, and avoid those things that seem to lead to pain for you. These may include alcohol, certain foods and spices, caffeine, and stress. Try keeping a diary for at least a month to zero in on what may be leading to your migraines, and then work on lifestyle changes.
- Birth control pills: Newer pills that allow women to have fewer periods can help them avoid the hormonal fluctuations that often trigger migraines. Talk to your doctor about the possibilities.
- Medications: There are a number of these available now. If over-the-counter pain relievers aren’t working for you (or you find yourself taking too many of them), ask about prescription pain relievers like Triptans that may be more effective. There are also preventive medications that are meant to reduce the frequency and severity of the headaches. These include high blood pressure drugs like beta-blockers and calcium channel blockers, which help maintain proper function of blood vessels, preventing them from constricting and causing migraine pain. Some antidepressants may also help.
- Butterbur: There has been some exciting research into herbal solutions for migraines lately. Butterbur, in particular, has been found in studies to be effective in helping to reduce the frequency of headaches. Several studies showed the potential of butterbur (diminishing frequency by at least 50 percent). A review by the American Academy of Neurology established Petadolex, a specific butterbur extract, as effective for migraine prevention. There are concerns, however, that some products may contain a toxic substance that has the potential to cause liver damage. Proper manufacturing removes this substance, and studies have shown Petadolex to be free of it, but long-term safety has not been established. Currently, only short-term use is recommended.
- Feverfew: This is another herb with some impressive studies behind it. In 2011, researchers found that 63 percent of participants with migraines who took a combination feverfew/ginger supplement experienced pain relief within two hours, while only 32 percent taking pain medication experienced pain relief within that time period. Another study showed that feverfew helped reduce migraine frequency by a little more than half per month. Some additional studies have shown mixed results, but feverfew doesn’t seem to be associated with any safety risks, so it may be worth a try. Pregnant women, however, are advised not to take it.
- Riboflavin (vitamin B2): Some studies have shown that higher doses of riboflavin can help reduce migraine frequency. In 2004, for instance, patients who took 400 mg of the supplement per day reduced frequency from four days per month to two days after three months. Other studies have shown similar results. The supplement is safe and well tolerated.
- Ginger: Ginger already has a good reputation for helping to reduce nausea, but did you know that it also helps tame inflammation? That means it can help to relieve some types of pain. A 2014 study compared ginger and sumatriptan, a prescription migraine pain reliever. Results showed that two hours after using either, patients experienced a decrease in the severity of pain. “The effectiveness of ginger powder in the treatment of common migraine attacks is statistically comparable to sumatriptan,” researchers wrote, while ginger created fewer side effects.
- CoQ10: CoQ10 is a vitamin-like substance naturally produced in the body, but we don’t produce as much as we age. Medications, particularly statin drugs (for reducing blood cholesterol) also reduce the CoQ10 we have. Research shows that CoQ10 supplements may help with a number of health concerns, like heart disease and even fatigue, but what about migraines? A 2002 study found that after three months, 61 percent of participants taking 150 mg/day had a greater than 50 percent reduction in frequency of migraines. A later study found similar results—48 percent of participants receiving 300 mg/day reduced frequency by greater than 50 percent.
- Biofeedback: This is a treatment technique in which you’re hooked up to biofeedback machines that give you information about what’s going on in your body. The machines may show you where you’re tensing up, for instance, or when your heart rate goes up. Using this information, you can learn to relax and gain better control over your bodily functions, which may help you reduce migraine pain. A 2009 study found that 35 percent of patients who completed a biofeedback program reported fewer severe headaches after three months, while 57 reported fewer headaches after 6 months. A 2010 study showed similar results.
- Acupuncture: Similar evidence has found that acupuncture may help to relieve migraine headaches. A 2008 study compared acupuncture to the prescription reliever Rizatriptan, and found that acupuncture provided a steady outcome improvement similar to the drug treatment. A more recent 2015 study also reported that acupuncture was an effective and safe treatment for short-term relief of frequent migraines.
“Migraine Fact Sheet,” Migraine Research Foundation, http://www.migraineresearchfoundation.org/fact-sheet.html.
“Quick Stats: Percentage of Adults Who Had Migraines or Severe Headaches, Pain in the Neck, Lower Back, or Face/Jaw, by Sex—National Health Interview Survey 2009,” CDC, December 3, 2010; 59(47):1557, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5947a6.htm.
“Key facts and figures about migraine,” Migraine Trust, http://www.migrainetrust.org/key-statistics.
“Migraine,” Mayo Clinic, June 4, 2013, http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/causes/con-20026358.
Simona Sacco, et al., “Migraine in women: the roles of hormones and their impact on vascular diseases,” J Headache Pain, April 2012; 13(3):177-189, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311830/.
Nasim Maleki, et al., “Her versus his migraine: multiple sex differences in brain function and structure,” Brain, July 28, 2012; 135(Pt 8):2546-59, http://www.ncbi.nlm.nih.gov/pubmed/22843414.
Carol Cruzan Morton, “Why Do Women Get More Migraines?” American Association for the Advancement of Science, August 13, 2012, http://news.sciencemag.org/plants-animals/2012/08/why-do-women-get-more-migraines.
Jim Schnabel, “Theory Behind Migraine Emerges,” Brain Work, The Dana Foundation, March 2008, http://www.dana.org/Publications/Brainwork/Details.aspx?id=43724.
Hayrunnisa Bolay, et al., “Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model,” Nature Medicine, 2002; 8:136-142, http://www.nature.com/nm/journal/v8/n2/full/nm0202-136.html.
Tietjen GE, et al., “Recalled maltreatment, migraine, and tension-type headache: results of the AMPP study,” Neurology, January 13, 2015, 84(2):132-40, http://www.ncbi.nlm.nih.gov/pubmed/25540306.
“Childhood Trauma Tied to Migraine Risk as Adult,” HealthDay News, July 3, 2015, http://consumer.healthday.com/public-health-information-30/domestic-violence-news-207/childhood-trauma-may-up-risk-for-adult-migraines-700726.html.
“Children Who Are Abused or Neglected More Likely to Experience Migraine as Adults,” American Academy of Neurology, [Press Release], December 24, 2014, https://www.aan.com/PressRoom/home/PressRelease/1330.
Thomas P. Bravo and Bert B. Vargas, “Migraine Preventative Butterbur Has Safety Concerns,” Neurology Times, January 28, 2015, http://www.neurologytimes.com/headache-and-migraine/migraine-preventative-butterbur-has-safety-concerns.
Danesch U, Rittinghausen R, “Safety of a patented special butterbur root extract for migraine prevention,” Headache, January 2003; 43(1):76-8, http://www.ncbi.nlm.nih.gov/pubmed/12864764.
Cady RK, et al., “A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine,” Headache, Jul-Aug 2011; 51(7):1078-86, http://www.ncbi.nlm.nih.gov/pubmed/21631494.
“Feverfew for preventing migraine,” Cochrane, http://www.cochrane.org/CD002286/SYMPT_feverfew-for-preventing-migraine.
Boehnke C, et al., “High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre,” Eur J Neurol., July 2004; 11(7):475-7, http://www.ncbi.nlm.nih.gov/pubmed/15257686.
Maghbooli M, et al., “Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine,” Phytother Res., March 2014; 28(3):412-5, http://www.ncbi.nlm.nih.gov/pubmed/23657930.
Rozen TD, et al., “Open label trial of coenzyme Q10 as a migraine preventive,” Cephalalgia, March 2002; 22(2):137-41, http://www.ncbi.nlm.nih.gov/pubmed/11972582.
Sandor PS, et al., “Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial,” Neurology, February 22, 2005; 64(4):713-5, http://www.ncbi.nlm.nih.gov/pubmed/15728298.
Mullally WJ, et al., “Efficacy of biofeedback in the treatment of migraine and tension type headaches,” Pain Physician, Nov-Dec 2009; 12(6):1005-11, http://www.ncbi.nlm.nih.gov/pubmed/19935987.
Deborah A. Stokes and Martha S. Lappin, “Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study,” Behav Brain Funct., 2010; 6:9, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826281/.
Enrico Facco, et al., “Traditional Acupuncture in Migraine: A Controlled, Randomized Study,” Headache, 2008; 48(3):398-407, http://www.medscape.com/viewarticle/572382.
Yanyi Wang, et al., “Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up,” Evidence-Based Complementary and Alternative Medicine, 2015; http://www.hindawi.com/journals/ecam/2015/920353/.