How Does Migraine Affect Women?
I know a lot of people with migraine disease, and most of them are women. Besides my brother, I didn’t personally know any men with migraine until recently. It turns out that migraine is the single most disabling disease worldwide for women under the age of 49. Why does migraine seem to affect women more than men, and what impact does it have on their lives?
Why Is Migraine More Prevalent in Women?
We know that 3 out of 4 people with migraine are women. Hardly an exclusively “women’s disease” but still definitely heavily weighted towards women. There seems to be a connection between migraine, women’s hormones, and changes in those hormones. A woman’s menstrual cycle, pregnancy, peri-menopause, post-menopause, hormonal contraceptives, and hormone replacement therapy can all contribute to migraine. Many women may have increased attacks before or during their menstrual cycle, known as menstrual migraine. The frequency and severity of attacks may also change during pregnancy, after childbirth, during perimenopause, and possibly even decrease after menopause – although sadly that is not a guaranteed thing, and for some women it can actually get worse after menopause! As with everything migraine, it’s complex.
Can Migraine Impact a Woman’s Career?
Although migraine often starts in early childhood and can last throughout our senior years, there do seem to be some trends when it is worse. In women, the prevalence of migraine peaks in the mid-30s. This is the time most women are building their careers. Debilitating migraine attacks may mean less productive workdays or more sick days than your colleagues without migraine. Women can face migraine triggers at their job, such as harsh lighting, scents from personal care products or strong cleaning chemicals, uncomfortable seating, or noise.
Requests for reasonable accommodations for people with migraine in the workplace should be accepted since migraine disease is considered a disability under the American Disabilities Act. However, all too often those accommodations are turned down, or people don’t know what to ask for or how to ask for them. You can read more about migraine in the workplace here. At the same time, these are often the childbearing years, adding to additional potential triggers from hormones, as well as often overwhelming guilt about not “being available.”
Are There Famous Women with Migraine?
Despite the often debilitating symptoms, migraine has not kept many women from reaching the top of their careers. Tennis player Serena Williams suffers from intense menstrual migraine attacks. Shea and musician Lady Gaga are in migraine treatment commercials. In 2008, singer Janet Jackson canceled live concerts due to vestibular migraine attacks. Actors Lisa Kudrow, Marcia Cross, Whoopie Goldberg, and Kristin Chenoweth also have migraine.
Cindy McCain, the wife of the late Senator John McCain, is a migraine awareness advocate. She has openly spoken about being misdiagnosed by a family practice doctor who told her she was simply stressed from raising 4 children. His advice was for her to go home, “sleep it off,” and “get over it.” And then there is Serene Branson, whose sudden migraine attack while she was reporting live for KCBS TV elevated awareness about frightening migraine symptoms like aphasia.
Do Women Face More Migraine Stigma?
Women’s pain is not taken as seriously as men’s pain. Medical professionals often see women as emotional, attention-seeking hypochondriacs, or simply less tolerant of pain. Many women self-report that their doctors have judged their pain by the amount of makeup they are wearing. “You can’t be in too much pain if you were able to put makeup on” is a common comment. Women already face stigma around changes in hormones, such as experiencing mood swings during their menstrual cycle. Migraine tends to increase this stigma. Often, women take on most family responsibilities, such as raising children, cleaning the house, and cooking meals, all while working a full-time job. Women are expected to manage all of this with ease, and doing so with migraine attacks makes it immeasurably harder. Yet, women in general are often seen as weaker and less able to handle stress than men.
Gender bias is when one gender is preferred over another. It is based on stereotypes of false beliefs. Unfortunately, this “gender bias” is seen frequently in doctors’ visits and even in emergency room situations. There is a tendency to blame “stress” or “anxiety” as the reason for symptoms, and tranquillizers are handed out more frequently than referrals to certified headache specialists for comprehensive disease management. Gender bias can keep women from accessing appropriate medical care, like in the case of Cindy McCain.
Raising Awareness the Right Way?
A few years ago, a fashion magazine asked female social media influencers to post pictures of themselves in “migraine pose.” To create this Instagram-famous pose, place one or both hands at your temples and pull your face up to tighten it. It is supposed to give the model a face framed beautifully by their hands. This, according to the fashion industry, is what a woman looks like during a migraine attack. Of course, a real migraine attack is a far cry from this beautiful pose. Migraine is often devastating both in its impact and the symptoms experienced. It’s not pretty to look at, and it’s certainly not “posed” or artificial.
As you can see, migraine can impact a woman’s life in many ways. If you are a woman with migraine, it’s important to advocate for yourself. Request reasonable accommodations at work. Talk honestly to your friends and family. Ask your primary care doctor to treat your migraine according to the guidelines from the American Headache Society. Don’t be afraid to request a referral to a certified headache specialist if migraine seriously impacts the quality of your life and treatments aren’t helping. Develop a Migraine Action Plan with your doctor that includes a variety of treatments. You have a right to appropriate and timely medical treatment! Most of all, remember that you are worth it. Migraine is NOT your fault – it is not caused by the fact that you don’t handle stress well. It is not “all in your head.”