Headaches. Just about everybody has them occasionally – and some unfortunate people experience them often. The term “migraine” often is used to describe a particularly severe and long-lasting headache, but it’s not always used accurately. You can have a horrible headache that is not a migraine – it could be a tension-type headache, a cluster headache, a sinus headache, a rebound headache or a symptom of another problem, such as meningitis.
Migraine headaches are considered one of the most disabling chronic medical conditions and about 12 percent of adults in the U.S. are “migraineurs” – that is, nearly 30 million people suffer from migraines. Recently, some researchers have come to believe migraine headaches are caused by an inherited genetic abnormality.
Three times more women are diagnosed with migraines than men; the female hormone estrogen is thought to play a role. Often, girls and young women will experience their first migraine headache around the time of their first menstrual period. For some women, migraines stop around menopause. For others, the onset of migraines coincides with menopause.
In men, migraines can start at any time from childhood on. Some headache specialists think men are underdiagnosed with migraines because they are less likely than women to seek medical attention for headaches. Also, men are more likely to medicate themselves with over-the-counter or illegal drugs.
Everyone who experiences migraines will describe their pain and symptoms in a different way. Some migraneurs have “classic migraines” that start with symptoms such as mood changes, loss of appetite, sensitivity to sight, sound and smells, and fatigue beginning hours or days before the actual headache.
Then, in the hour before the headache, an “aura” can occur. Auras usually are described as visual distortions similar to bright flashing lights. However, not everyone with migraines experience these symptoms.
Once a migraine headache starts, most people feel pain on just one side of the head, but 40 percent have pain on both sides. The pain often is described as pounding or throbbing and sufferers may feel nauseated, irritable, depressed, confused, dizzy and weak. The headache can last for many hours or even days. Usually, people with migraines want to rest in a dark, quiet place.
For those of us who have never experienced a truly severe and long-lasting headache, it can be hard to understand how debilitating migraines can be. Even after the pain of a migraine has subsided, its effects can linger in the form of fatigue, irritability and lack of concentration.
People with severe migraines may have headaches many times each week or month.
Some migraineurs know exactly what triggers their headaches – things such as lack of sleep, weather changes, missed meals, emotional stress, certain foods or exposure to strong perfume. If triggers are identified, avoiding them can minimize the number of migraines. But, for many, migraines seem to come randomly.
There are two approaches to treating migraines. One way is to get treatment when the symptoms begin. Most people with migraines treat their pain with a variety of medications – over-the-counter drugs such as ibuprofen or acetaminophen in maximum doses may work for some people; others depend on prescription medications. Some medications, such as Imitrex, are effective if taken as a self-administered injection at the first sign of a migraine.
The second approach to the treatment of migraines is preventative medication that is taken daily in an attempt to decrease the frequency and severity of migraines – drugs such as propanolol, amitriptyline, divalproex sodium and topiramate. Some of these medications also are used for the treatment of depression or seizures.
Some people with migraines have found relief with acupuncture or biofeedback.
It’s my hope everyone who suffers from migraines or any type of severe headache can educate themselves and find a health care provider who will listen carefully and help them find ways to prevent and treat their pain. The challenge is that everyone who suffers from headaches will have different triggers and will find relief in different ways. The trick is to learn about all the treatment options that exist and try them in a rational way until you find what’s best for you.
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