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HeadWay Issue #230 - Are Women Missing Available Migraine Treatments?
May 21, 2024

In this issue:

Are Women Missing Available Migraine Treatments?

Say what?! Menstrual Migraine etc.

Are Women Missing Available Migraine Treatments?

A new study is raising some important issues for women with migraine. Specifically, menstrual migraine

The study, from last month's American Academy of Neurology 2024 Annual Meeting, used the 2021 U.S. National Health and Wellness Survey to identify women with migraine.

The study used the simple MIDAS test (Migraine Disability Assessment Test) to measure migraine and disability. The research especially focused on menstrual migraine.

Study author Dr. Jessica Ailani noted that there can be an even greater migraine burden as women get older, because women may have more regular menstrual cycles and also greater hormonal changes.

Menstrual migraine, in spite of its relative predictability, can be notoriously difficult to treat. In this study, these "once-a-month" migraine attacks lasted 8-9 days, and more than half of the women reported moderate to severe disability.

That deserves a -- ! -- , because too many people still think about a "monthly headache" as a brief inconvenience. But I'm sorry to say, that adds up to over 27% of your month!

Menstrual migraine is often not properly diagnosed. But Dr. Ailani did express concern about the lack of good treatment. Often patients are only taking "painkillers", and perhaps avoiding preventative medications or migraine-specific treatments. She makes a good point:

"Preventive treatments are used less frequently than acute treatment for migraine. In my opinion, this is because preventive therapy is a long-term commitment by both a woman and her clinician to improving the disease process. Migraine is a life-long brain disease without a cure, and the goal of preventive therapy is to reduce disease burden and improve quality of life.

That is to say - are women missing out on good treatments because it's so much easier to say "take two painkillers and have a nice day"?

We may blame some doctors (there are good ones and bad ones), but we as patients are also sometimes reluctant to see a specialist or look for long term solutions.

To be fair, this study was supported by Pfizer, and Dr. Ailani is a paid advisor. So you know that there are some who would want you to go for a more expensive medication - and some specific ones at that.

But neither should we avoid what works well. There does need to be more awareness, and a greater commitment to proper diagnosis and ongoing treatment, whether that involves changes in diet, an older medication, or an expensive medication. Or the many other treatments that are available.

The fact is, women are often missing out on good treatments, because many of these migraine attacks are statistically preventable.

Take the time to find a doctor who will take your headaches seriously (if possible, a specialist), and don't give up. I entirely agree with this statement from Dr. Ailani: "If you have migraines related to your menstrual cycle, discuss this with your gynecologist or neurologist. There are treatments that can help, and if the first treatment tried does not work, do not give up."

More to read:

Say what?! Menstrual Migraine etc.

This is an excellent time for a quick review of terminology. What exactly are those "monthly headaches"? Assuming that they are migraine attacks, they still may go by different names.

Curious? Check out this quick graphic: Do You have Menstrual Migraine?

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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