Migraine headaches, the debilitating vascular malady that plagues approximately 8 percent of American women, has been identified as intensifying during peri-menopause, according to a new research study, as identified by study coauthor Richard B. Lipton, MD, director of the Montefiore Headache Center in New York. The results were published in the Headache medical journal, according to Pharmacy Today.
Migraines are episodic headaches that tend to begin in late childhood to early adolescence, and there seems to be a strong genetic component, though the reasons people have migraine headaches are not completely understood. The headache is known to have several phases. The first is the prodromal phase, which can begin days to weeks before the headache, and may result in altered mood affect, such as depression or euphoria. Immediately afterwards, persons who suffer migraines may develop the aural phase, in which they smell scents that are not actually there or see flashing lights in front of their eyes. Next is the infamous pain stage, which may last hours to days and is characterized by photophobia (light hurting one’s eyes), nausea, vomiting, and severe pain on one side of the head. This is thought to be caused by vasospasm, or contracting of blood vessels in the head.
While it’s known that certain things can contribute to the development of headache, the exact reasons for causation are unknown. It’s known that certain things can contribute to a migraine such as lack of sleep, alcohol, aged cheeses, strong scents, missing meals, and stress. It has been noted that women tend to get migraines just prior to their periods, so a hormonal correlation has already been established.
For women, just prior to the start of menopause, estrogen levels drop. This leads to the cessation of ovulation and menstruation, along with myriad other issues such as breaking out in a sweat, irritability, and sometimes weight gain. Researchers noted that in the sample of women, which was over 3,000, the incidence of migraine days ten times or more a month went from 8 percent in the pre-menopausal group to 12.2 percent in the peri-menopausal group. After menopause was complete and hormones were situated, the incidence of migraine was still higher at 12 percent, meaning that there’s a possibility that estrogen plays a protective factor against migraine headache, although the reasons for this possible correlation are unclear.
Migraine is one of the number one causes of “loss of work” days, or reasons that people in the workforce call in sick. This lack of productivity costs the United States thousands of dollars per year, not to mention pain and suffering to those who experience migraine. Some individuals have such severe migraine headaches that they must take disability because they miss so much work. Migraine headaches are also closely associated with depression, anxiety, and fibromyalgia. Dr. Lipton says that patients should take heart that the trigger of menopause is temporary and will eventually level out, according to the results of the study.
“If headache frequency and severity warrant preventive therapy, doctors can reassure patients that once the menopausal transition is complete, there is a good chance that preventive medicines will no longer be necessary.”
Preventive therapy in the past has included taking beta blockers, which seem to suppress vasospasm that trigger headaches but may lead to other problems such as low blood pressure, dizziness, and light-headedness. Other treatments, such as Imitrex, works well to stop a migraine in its tracks, but has been associated with cardiac problems in some patients. Botox has been a promising new therapy, essentially paralyzing blood vessels so that they cannot spasm, but this also carries a risk of allergic reaction or paralyzing muscles that are necessary to breathe properly.
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