If you’re one of the 4.9 million Australians who suffer from migraines, you’ll know they’re so much more than just a headache.
From fatigue and difficulty concentrating to nausea and sensitivity to light and sound, it’s often the symptoms that come with the throbbing head that make migraine’s so debilitating.
Making migraines even harder to navigate is the fact they’re dealt with in private, so people are often not believed – and even patronised – when they need to cancel plans or can’t work.
Migraines cost the economy $35.7 billion a year, mostly in lost productivity and health system costs. They also predominantly affect women – 71 per cent of sufferers are female.
“People can’t see migraines, so they have trouble appreciating the severe impact they have,” explains Dr Sarah White, CEO of Jean Hailes, a national not-for-profit organisation dedicated to improving the knowledge of women’s health. “A lot of employers still think it’s just a headache and that you should take a couple of painkillers and get on with it.”
Unfortunately, just “getting on with it” isn’t an option for most. What triggers an attack varies, but they are often brought on by common factors such as stress, hormonal changes, a lack of sleep and certain foods. For some, they’re an unbearably regular occurrence.
Of the more than 20 per cent of Australians who suffer from them, 7.6 per cent experience chronic migraines, which is defined as 15 or more migraine days a month.
“There’s a mismatch in public perception and reality for many people living with migraines,” explains Carl Cincinnato, whose first-hand experience led to his advocacy role as a Director of Operations with patient advocacy group Migraine & Headache Australia.
“It’s common for adults who experience a migraine attack for the first time to rush to the emergency department because they think they’re dying or having a stroke. That just speaks to the severity.”
Cause and effect of migraines
As widespread as migraines are, there’s still a lot we don’t know. We’re just scratching the surface when it comes to researching their causes, and we know even less about why three times as many women as men suffer. For women aged 18 to 49, migraine is the leading cause of disability throughout the world.
A large piece of the puzzle is hormonal, but the connection isn’t completely understood. Migraines are often most common and intense during a woman’s reproductive years, with researchers estimating 50 to 60 per cent of women with migraines experience them in the lead-up to or during menstruation, triggered by a drop in oestrogen levels.
“The exact mechanism that initiates a migraine is unknown, but there’s a specific network in the brain that gets activated,” explains Dr Jason Ray, a consultant neurologist and research fellow at the Alfred and Monash University.
“There are factors that make it easier or harder to trigger an attack if you happen to be one of the people with the right genetic make-up to experience migraine attacks.”
Getting the right help
When it comes to treatment, Dr Ray says it’s a three-pronged approach: “Lifestyle factors to help reduce the burden and the frequency of migraines, acute treatments to reduce the pain of a migraine attack once it has started, and then preventative therapies to reduce the frequency that a person experiences a migraine in terms of the days of the month.”
If you suffer regular migraines, instead of trying to describe the pain to your doctor, Dr White says it’s more effective to explain the impact it has on your life.
“Pain is a very nebulous thing to describe. It matters less if the pain is stabbing or aching and more that the pain is so bad it stops you from getting out of bed for two days of the week,” she says.
A good place to start is by keeping a record of your symptoms and triggers, either with a diary or an app like Migraine Buddy.
“It can be really helpful for a doctor because they would treat someone very differently if they had one attack a month that selfresolved within two hours versus someone who’s having an attack eight times a month with each lasting two days,” says Carl.
While there still isn’t a cure, treatment options have advanced in recent years, so it’s worth checking in with your GP to see if your circumstances have changed.
“New preventative therapies that have come to Australia in the last few years have changed the landscape for people who’d previously had limited options,” confirms Dr Ray.
Migraine or headache?
Not sure if you’re having a migraine or a headache? Asking yourself these three questions will give you a good indication. If you answer “yes” to more than one, it’s worth checking in with your GP.
1. Has a headache limited your activities for a day or more in the past three months?
2. Are you nauseated or sick to your stomach when you have a headache?
3. Does light bother you when you have a headache?
Avoiding triggers
According to Migraine & Headache Australia, common migraine triggers include:
• Menstrual/hormonal changes.
• Consuming chocolate, coffee or alcohol.
• Strong smells like paint, perfume or chemicals.
• Changes in the weather.
• A lack of sleep or fatigue.
• Prolonged periods of stress.
• Bright or flickering lights.
• Loud sounds.
Jean Hailes for Women’s Health is a not-for-profit organisation providing health services for women across Australia.
