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Migraine Diagnosis May Be
Missed in Women
Jennifer Wider, M.D.
Chances are you’ve had a headache. Most people have. But if
you’re a woman and suffer from migraines, you may not have
received a proper diagnosis. In fact, roughly 60 percent of
women suffering from migraines have never even been
diagnosed with the condition, according to the National
Migraine Awareness Group based in Alexandria, Va.
Katrena Potashnick, a long-time migraine sufferer from
Springfield, Mo., knows the statistics all too well.
“I suffered from horrible headaches from 1988 to 2003. It
took all those years to get a proper diagnosis,” Potashnick
said. “I went to the Headache Care Center [in Springfield]
in the spring of 2003 and finally was diagnosed with
migraines.”
On average, women suffer from all types of headaches more
frequently than men. Migraines are roughly three times more
common in women. This disparity between the sexes increases
from the onset of puberty through a woman’s mid-40’s, and
then starts to decline after menopause. This pattern
strongly suggests that estrogen levels play an important
role in the higher prevalence among women.
Headaches can make getting through the day a little bit
harder, but the pain from a migraine can be debilitating.
The pain typically affects one side of the head and can be
sharp or throbbing in a nature. The pain can range from mild
to severe and interrupt daily activities. Sufferers can
become sensitive to light and sound and may experience
nausea and vomiting. The attacks can last for a few hours or
a few days. About one-fifth of sufferers experience an aura,
or visual disturbances before the actual onset of the
headache.
“My most common symptoms were fatigue, sinus congestion,
nosebleeds and a horrible headache with blurred vision,”
Potashnick said. “Vomiting came with it in the later years.”
Diagnosing a migraine can be difficult because the symptoms
and triggers vary from person to person, as do responses to
treatments.
“The most common symptom of a migraine is nausea, although
it is not necessary for the diagnosis,” said Stewart J.
Tepper, M.D., co-director of the New England Center of
Headache, in Stamford, Conn., and assistant clinical
professor of neurology at Yale University School of
Medicine. “Almost any stable pattern of at least six months
of episodic, disabling headache is considered a migraine.”
Studies have shown that migraines in women are often
triggered by the onset of puberty, synthetic estrogens in
birth control pills, and hormonal replacement therapy. In
addition, migraines are frequently experienced right after
women give birth when estrogen levels sharply decline.
“In general, a drop in estrogen, especially at the beginning
of menses, is a trigger for migraine headache,” Tepper said.
Migraine headaches are treatable. Because many people suffer
from migraines without a proper diagnosis, it is vital to
identify the type of headache you suffer from in order to
get the necessary treatment. There are a variety of
medications, including general pain relievers,
migraine-specific agents, beta-blockers and
anti-depressants, proven to help. It is also possible to
prevent migraines by learning to avoid potential triggers.
Working closely with a health care professional will
optimize your ability to manage and treat migraine pain
effectively.
Individuals can learn more about migraines and take a
headache assessment quiz by visiting this link
www.womenshealthresearch.org/migraine.htm.
Additional information is also available from the National
Headache Foundaton, on the Internet at
www.headaches.org.
© October 13, 2005 Society for Women's Health Research
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