Women And Headache
Why are Headaches of Particular Concern to Women?
Headaches are a particular concern for women for reasons
other than their frequency. In women with migraine, menstruation is a common
trigger; this is referred to as "menstrual migraine". This is different from
the headache associated with premenstrual syndrome (PMS), which is more mild.
In women taking birth control pills, migraines may start, worsen, or increase
in frequency (although some women experience the opposite effect). Changing
to a lower dose birth control pill may help. The good news about menopause
is that migraines usually decrease dramatically. Taking estrogen replacement
therapy (ERT) may cause migraines to continue, however. This is not
a reason not to take ERT, just another issue to discuss with your health
care provider if it affects you.
Headaches and Pregnancy:
In most women, pregnancy actually decreases the frequency and severity
of headaches. In some women, however, migraines may first appear during pregnancy
and in some, they may worsen. Unfortunately, there is no medication other
than Tylenol that has been proven safe and effective throughout pregnancy.
As with any medication in pregnancy, discuss the benefits versus risks
of treatment even with over the counter medications: there are times when
your physician may recommend other headache remedies. One prescription medication,
sumatriptan (Imitrex®) has recently been found to be associated with preterm
labor, however, so this medication should be avoided in pregnant women.
Postnatal or Postpartum Headaches:
After labor and delivery, it is very common for mothers to suffer from headaches,
usually tension-type. Migraine sufferers may also get postnatal migraines,
too, although the headache will probably be milder than a typical full-blown
attack. Postpartum headaches correlate with the sharp fall in estrogen and
progesterone levels that follow labor and delivery. This sharp decline is
often avoided by women who breast feed.
Psychosocial Impact of Headaches in Women:
Nearly half of women migraine
sufferers in one survey were unaware of the prevalence of migraine. Many women
of these women felt alone, isolated, misunderstood, or ashamed. They often
questioned the seriousness of their condition and avoided seeking treatment.
Some women suffer in silence out of fear of being perceived as "weak", emotional,
hysterical or unable to handle stress. Ironically, the multiple stressors and
roles that many women juggle may contribute to exacerbating a migraine once
it starts. Many women do not have the "luxury" of retreating to a restful,
quiet environment to get the respite they need. Recent research shows that
one in three female sufferers of migraine reported that it has affected their
ability to be in control of their lives. Of these women, nearly half (46%)
claimed they could not control their plans or activities, or even function during
a migraine attack; one in five reported lost confidence in their ability to
do their work, could not think clearly, felt "extremely ill" or felt "depressed".
According to most of these women, marriages and other relationships suffer as
a result; having migraines also affects women's level of sexual satisfaction.
While the diagnosis may be a migraine, this diagnosis can only be made after other serious and even life-threatening problems are considered and ruled out.