Hormonal changes can be painful for women

The National Weekender

HORMONAL changes in women , among other things, may help to trigger migraines.
Women with a history of migraines often report headaches immediately before or during their periods, when they have a major drop in estrogen.
Other triggers are:

  • Others have an increased tendency to develop migraines during pregnancy or menopause.
  • Hormonal medications, such as oral contraceptives and hormone replacement therapy, also may worsen migraines. Some women, however, find their migraines occur less often when taking these medications.
  •  Foods: Aged cheeses, salty foods and processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks.
  •  Food additives: The sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods, may trigger migraines.
  •  Drinks: Alcohol, especially wine, and highly caffeinated beverages may trigger migraines.
  •  Stress: Stress at work or home can cause migraines.
  •  Sensory stimuli: Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — can trigger migraines in some people.
  •  Changes in wake-sleep pattern: Missing sleep or getting too much sleep may trigger migraines in some people, as can jet lag.
  •  Physical factors: Intense physical exertion, including sexual activity, may provoke migraines.
  •  Changes in the environment: A change of weather or barometric pressure can prompt a migraine.
  •  Medications: Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
    Several factors make you more prone to having migraines, including:
  •  Family history: If you have a family member with migraines, then you have a good chance of developing them too.
  •  Age: Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
  •  Sex: Women are three times more likely to have migraines. Headaches tend to affect boys more than girls during childhood, but by the time of puberty and beyond, more girls are affected.
  •  Hormonal changes: If you are a woman who has migraines, you may find that your headaches begin just before or shortly after onset of menstruation.
    They may also change during pregnancy or menopause. Migraines generally improve after menopause.
    Some women report that migraine attacks begin during pregnancy, or their attacks worsen. For many, the attacks improved or didn’t occur during later stages in the pregnancy. Migraines often return during the postpartum period.
    Also, some people experience complications from migraines such as:
  •  Chronic migraine: If your migraine lasts for 15 or more days a month for more than three months, you have chronic migraine.
  •  Status migrainosus: People with this complication have severe migraine attacks that last for longer than three days.
  •  Persistent aura without infarction: Usually an aura goes away after the migraine attack, but sometimes aura lasts for more than one week afterward. A persistent aura may have similar symptoms to bleeding in the brain (stroke), but without signs of bleeding in the brain, tissue damage or other problems.
  •  Migrainous infarction: Aura symptoms that last longer than one hour can signal a loss of blood supply to an area of the brain (stroke), and should be evaluated. Doctors can conduct neuroimaging tests to identify bleeding in the brain.
    Until recently, experts recommended avoiding common migraine triggers. Some triggers can’t be avoided, and avoidance isn’t always effective. But some of these lifestyle changes and coping strategies may help you reduce the number and severity of your migraines:
  •  Transcutaneous supraorbital nerve stimulation (t-SNS): This device (Cefaly), similar to a headband with attached electrodes, was recently approved by the Food and Drug Administration as a preventive therapy for migraines. In research, those that used the device experienced fewer migraines.
  •  Learn to cope: Recent research shows that a strategy called learning to cope (LTC) may help prevent migraines. In this practice, you are gradually exposed to headache triggers to help desensitise you to them. LTC may also be combined with cognitive behavioral therapy. More research is needed to better understand the effectiveness of LTC.
  •  Create a consistent daily schedule: Establish a daily routine with regular sleep patterns and regular meals. In addition, try to control stress.
  •  Exercise regularly: Regular aerobic exercise reduces tension and can help prevent migraines. If your doctor agrees, choose any aerobic exercise you enjoy, including walking, swimming and cycling. Warm up slowly, however, because sudden, intense exercise can cause headaches. Regular exercise can also help you lose weight or maintain a healthy body weight, and obesity is thought to be a factor in migraines.
  •  Reduce the effects of estrogen: If you are a woman who has migraines and estrogen seems to trigger or make your headaches worse, you may want to avoid or reduce the medications you take that contain estrogen.
    These medications include birth control pills and hormone replacement therapy. Talk with your doctor about the appropriate alternatives or dosages for you.

–  Source: mayoclinic.org