Migraine headaches are a gender specific healthcare issue, especially since many migraines are hormonally triggered. As such, providers in the field of gynecology need to be inclusive of this issue in treating the “whole” woman. Currently, we as healthcare providers do a very poor job of diagnosing and properly treating migraines early. When we fail to do this, infrequent migraines can progress into a chronic medical condition. Recently, Dr Lisa Larkin (a board-certified OB/GYN) sat down with the North American Menopause Society to discuss this fact. Here is what I learned.
- Migraines are highly prevalent – 18% of women will experience them, they often go undiagnosed and are therefore an unmet medical need in the care of women.
- Migraines have a tremendous impact on the quality of life of many women, and especially on their ability to be productive in the workplace.
- Often, they are triggered by hormonal changes and we do see them increase in frequency around the time of perimenopause.
When migraines first present, they are usually infrequent. If we don’t do a proper job of diagnosing and treating them early, migraines can progress to chronic headaches which then become harder to manage. “Chronic” is a loose term, but it is generally considered anything more than 6-10 episodes per month. Anyone who has progressed to this point should be having a conversation with their medical provider about preventative treatment.
In terms of treatment options, triptans are a class of medication we have had in our arsenal for a very long time. These are usually considered abortive medications, meaning to be used at the time of migraine onset. Despite being very effective, they have unfortunately been underused. There is also a limit on the number of times they should be used over a given period of time.
The good news is that in the past few years, a lot of great research has been done in this field which has led to some really excellent new treatment paradigms. We now know that the Trigeminal nerve and molecules called “CGRP” are involved. These new therapies are directed right at CGRP and the trigeminal nerve, which render them very effective with a low side effect profile. The downside to these treatments is that they are mostly given in the form of injections, which could be a potential barrier to their use.
Despite this, we are excited to have some new options to treat migraine headaches that will hopefully change the approach to treatment going forward. It is the responsibility of the women’s health provider to educate herself on their use, and implement them in her practice.
Menopausal symptoms can sometimes interfere with your quality of life. For more information on treatment, contact Maze for a free phone consultation. Our medical practitioners are happy to help.