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February 17, 2023

Women and Migraine Headaches: What You Need to Know

ThedaCare Family Medicine Physician Helps Women Understand Prevention, Symptoms and Care Options

For those who have experienced migraine headaches, the pain is unmistakable – a severe headache, often on one side of the head, sometimes pulsing, sometimes with other problematic symptoms such as nausea and sensitivity to light or sound.

For sufferers of migraines, these headaches can be debilitating. According to the Migraine Research Foundation, nationwide, 39 million people in the U.S, suffer from migraines –and three out of four of them are women.

“Women are more likely to suffer from migraine headaches, which can be strongly tied to fluctuations in estrogen,” Dr. Katherine Nonweiler, Family Medicine Physician with ThedaCare Physicians-Kimberly. “Knowing the symptoms, triggers and how to care for yourself can help alleviate the frequency and the impact these headaches can have.”

The Onset of Migraines

Some sufferers may recognize when a migraine is about to hit, with possible warning symptoms appearing before the headache, which can develop in several stages (though not everyone experiences all of them).

“The prodrome stage may start a day or two prior to a headache,” Dr. Nonweiler said. “Symptoms can include mood changes, food cravings, constipation or fluid retention, increased urination, yawning or a stiff neck.”

An aura can occur immediately prior to the onset of head pain, and can include visual phenomena, pins-and-needles in the body or even difficulty speaking. The attack can manifest differently, usually with pain occurring on one side of the head, but sometimes both. The pain can be throbbing and sometimes constant, but usually very strong. Light and sound can make the pain worse. The headaches can last up to 72 hours if left untreated.

The postdrome phase may leave a migraine sufferer feeling drained and confused, with pain returning briefly with sudden head movement.

The Hormone Connection

People who are at greater risk of developing the headaches include those with a family history that includes migraines. Age is a factor as well. Headaches tend to become less frequent and intense after a person passes their 30s. People who experience them often have their first one as a teenager, especially women, who are three times as likely to have migraines.

“Migraines can be triggered by fluctuations in estrogen, and for women who do experience migraines, the first might happen around the onset of menstruation,” said Dr. Nonweiler. “Menstrual periods, pregnancy and the onset of menopause can also impact migraine occurrence.”

Oral contraceptives and other hormonal medication might make migraines worse for many women, though some find that these medications help diminish the frequency of the headaches.

“Many other external factors also can trigger migraines or intensify them,” Dr. Nonweiler said. “Patients who experience migraines may be able to alleviate the frequency or severity by making some lifestyle changes.”

Lifestyle changes might include:

  • Avoiding alcohol, particularly wine.
  • Switching to decaf, as caffeine can be a trigger.
  • Reducing stress.
  • Avoiding certain sensory stimuli such as loud noises, bright or flashing lights, and strong smells.
  • Getting enough sleep and keeping a regular sleep schedule.
  • Avoiding excessive physical exertion.
  • Avoiding salty and processed foods, as well as aged cheeses. Certain additives including aspartame and monosodium glutamate (MSG) also can trigger migraines. Fasting also can trigger migraines.
  • Avoiding overuse of painkillers, particularly aspirin, acetaminophen, and medicines that contain caffeine.

Changes in weather, such as fluctuations in barometric pressure, also can bring on migraine headaches. They can also be triggered by bright sunlight, extreme heat or cold weather, dry air, stormy weather or other elemental factors.

“It may help to keep a migraine diary to record the factors that may be triggering the onset of your headaches,” Dr. Nonweiler said. “This can include keeping track of your food and what’s happening with the weather.”

Staying in on days that are likely to trigger your migraines, along with making other healthy lifestyle changes, can help lessen the frequency of the headaches, she said.

Taking Care of a Migraine

When a migraine is unavoidable, there are ways that you can help diminish their impact.

“Relaxing in a dark and quiet room can help alleviate some pain from a migraine, as light and sound can intensify the headaches,” Dr. Nonweiler said. “Hot or cold compresses also can help, with heat helping to relax stiff neck muscles and cold helping to numb the pain.”

Sipping a small amount of a caffeinated drink also can help, but too much caffeine can interfere with needed sleep and cause a withdrawal headache later.

“If you have frequent migraines, I would recommend that you speak with your primary care provider to discuss other treatments or therapies that might help you,” Dr. Nonweiler said.

While patients may feel the need to be seen for their migraines immediately, there are options other than going to the Emergency Department.

Patients can get same-day care at ThedaCare Urgent and Walk-In care clinics, as well as at many of primary care clinics. When community members visit thedacare.org/get-care-now/urgent-care/, they can save a spot at urgent care and see wait times.

Urgent care also offers expanded hours. Many sites are open from 7:00 a.m. to 7:00 p.m., and they have weekend and holiday hours. Scheduling through MyThedaCare allows people to see the availability of a provider, as well as that of others on their care team, and those at nearby clinics.

Patients should seek immediate emergency care for headaches when they are:

  • Sudden, severe and seem to come out of nowhere.
  • Following a head injury.
  • Accompanied by fever, stiff neck, numbness or weakness in the body.
  • Accompanied confusion or double vision.
  • Chronic and get worse with exertion or coughing.

These symptoms may indicate a more serious medical condition such as a stroke or other concerns that need immediate attention.

“While migraines are common, we understand they can have a serious impact on someone, said Dr. Nonweiler. “We are here to provide care options to get you back to living your best life as soon as possible.”

About ThedaCare

For more than 110 years, ThedaCare® has been committed to improving the health and well-being of the communities it serves in Northeast and Central Wisconsin. The organization delivers care to more than 600,000 residents in 17 counties and employs approximately 7,000 health care professionals. ThedaCare has 180 points of care, including eight hospitals. As an organization committed to being a leader in Population Health, team members are dedicated to empowering people to live their unique, best lives. ThedaCare also partners with communities to understand needs, finding solutions together, and encouraging health awareness and action. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving specialists the ability to consult with Mayo Clinic experts about a patient’s care. ThedaCare is proud to partner with Children’s Wisconsin and Froedtert & the Medical College of Wisconsin health network to enhance convenient access to the most advanced levels of specialty care. ThedaCare is a not-for-profit health system with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs, as well as primary care.

For more information, visit thedacare.org or follow ThedaCare on social media. Members of the media should call Cassandra Wallace, Public and Media Relations Consultant at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.