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Hormonal changes can trigger painful migraines

Editor’s note: This story by Frances Womble was published in the Healthy Living section on March 4, 2012.

BY FRANCES WOMBLE

At times in her life, Kathy Paz has worried that she might have multiple sclerosis, or even have suffered a stroke. But after many tests and visits with doctors, Paz, 31, now knows her symptoms stem from migraines.

The headaches she suffers can cause not only pain but also problems—including numbness, paralysis and loss of speech—that mimic the signs of other conditions, including strokes and MS.

While severe head pain is commonly associated with migraines, sufferers also can endure a range of  problems including nausea, vomiting and extreme sensitivity to light.

“It starts with a tight feeling around the head, almost like you’re wearing a hat that is too tight,” Paz said of what she feels.

Paz said she began experiencing migraines in her teen years, and  they worsened after she gave birth in her 20s.  She noticed the migraines occurred most frequently during ovulation, the time when a woman’s hormone levels are at their highest.

She isn’t alone in finding a connection between migraines and hormones.

The National Headache Foundation says 29.5 million Americans are migraine-suffers. According to the foundation, women are three times as likely to experience migraines as men, and 60 percent of female migraine sufferers attribute the headaches to their menstrual cycles. 

“There is absolutely a connection between migraines and hormones,” said Dr. Mahan Chehrenama of the Neurology and Headache Treatment Center in Alexandria. “It is well-established that the prevalence and incidence of migraine is disproportionately higher in women, and that is generally felt to be as a result of estrogen on the central nervous system.”

WHAT IT’S LIKE

The onset of a migraine can be frightening and can severely limit a person’s ability to function.

Paz said she saw multiple neurologists before being diagnosed with hemiplegic migraines, a debilitating type that affects vision, muscle control and body sensation, speech and hearing, according to the Mayo Clinic.

Because of her migraines, “I have a hard time working,” Paz said.

Like many sufferers, she found the fluorescent lights in her work office could trigger a migraine.

Beth McBride, a 48-year-old woman who first experienced intense migraines during puberty,  also found that fluorescent lights at work  trigger her attacks.

“When I worked for the government, I learned to have maintenance turn off most of the lights over my desk,” McBride said. “Before that, I would have to go in the bathroom or to the nurse’s office to lie down in a dark room with a trash can beside the bed.”

Now, McBride, of Spotsylvania County, works from home, and she said that helps with some of the triggers. She shares Paz’s inability to function during a migraine.

“Your life is at a standstill,” McBride said.

When the migraines are too painful to manage on her own, McBride said, she asks her husband to drive her to her doctor for a shot of a medicine that can minimize her symptoms.

“It isn’t safe to drive with a migraine,” McBride said.  “Once, I threw up on the side of the road on [Interstate 95] the pain was so bad.”

WHAT TRIGGERS THE PAIN

Along with menstruation and fluorescent lights, the National Headache Foundation says migraine triggers can include:

  • Stress.
  • Skipping meals.
  • Excessive noise.
  • An altered sleep schedule.
  • Depression.
  • Certain foods.

“Anything can trigger a migraine,” Paz said.  “Even bright sunshiny days.”

Leslie Martin, 43, of Fredericksburg said red wine seems to bring about migraines for her, as do beer and chocolate during her period.  So, the last time she drank a glass of red wine was 15 years ago, she said.

Stress is another big trigger, particularly during menstruation, Martin said.

“I know mine are tied to my menstrual cycle,” she said.  “For almost two decades now I’ve seen the regular connection between hormones [and migraines].”

One of these connections was the absence of a migraine when she was pregnant and breast-feeding.

“Pregnancy is the best thing I’ve found [to stop migraines],” she said.  “But I’m not willing to have 20 kids.”

So she’s tried medication. Due to her body building up tolerance to migraine medication, Martin said, she is currently on her fourth migraine prescription.

COPING AND TREATING

After suffering  for several decades, McBride said, she found some treatments to take the edge off. But nothing is a quick fix. And while prescription medications help treat her symptoms, McBride said they also come with unwanted side effects.

“The rebound headaches from the meds can be just as bad,” she said.

Several prescription medications are available to help treat migraines. Some act by essentially stopping migraines in their tracks, if taken at the earliest signs of a migraine and before the pain becomes severe.

Effectiveness varies among sufferers, who should consult with their doctors for help finding the best medicine for them.

The National Headache Foundation notes that alternative approaches also can help; some women find birth control pills helpful while others find the pills bring on or intensify their migraines. Similarly, some people find caffeine helpful while others notice the opposite effect.

Chehrenama, the headache specialist, said the effectiveness of birth control pills as migraine treatment depends on the type of migraine.

“Caffeine is a double-edged sword,” Chehrenama said. “A little can help headaches, and a lot can worsen headaches. Different patients have different degrees of sensitivity and tolerance to caffeine.”

Chehrenama said regular sleeping and eating schedules, frequent exercise and a fresh food diet can help prevent migraines.

HORMONES AND HOPES

Because of the connection between migraines and hormone levels, experts say the headaches can intensify as women approach and enter menopause.

Chehrenama said the impact of menopausal sleep disruptions can worsen headache patters during this time. But good news—hormone-related migraines should cease over time.

“For most female patients, migraines do seem to subside after the early years of menopause,” Chehrenama said.

Because of this, Martin said she’s hoping for menopause to happen sooner rather than later.

“I’m now just actively hoping for menopause so I could see the back of these!” she said.

Meanwhile, migraine sufferers find ways to cope. McBride said when her migraines come on, she just wants to be left alone. They prevent her from cleaning, showering or even cooking because the smell of food makes her headache worse. The symptoms make it “really hard” to care for her son, who has autism.

“There is just no functioning,” she said.

Frances Womble:  540/374-5444

fwomble@freelancestar.com

 

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