For many sufferers, migraine is a chronic disease that significantly diminishes their quality of life.
There are 3 main types of non-drug treatments for migraine.
These therapies promote general good health and well-being. They can improve your quality of life. Their success in treating migraine is difficult to measure and may depend on many things, like the therapist, the length of treatment, and your commitment to regular practice.
These therapies can be tried alone or in combination:
Exercise programs are frequently recommended to promote health, control weight, and prevent disease. Migraine sufferers typically are less physically active than those who don’t suffer. They often avoid exercise, worrying that the exercise itself will aggravate or trigger a migraine.
Sufferers who follow certain common-sense guidelines can improve their quality of life and increase their aerobic endurance and flexibility without aggravating or triggering their migraines. Here are some tips:
Menstrual Migraine: Menstrual migraine is an attack that occurs up to 2 days before and up to 3 days after your period begins. It’s usually more severe and more difficult to treat than other types of migraine. 7-19% of women get menstrual migraine. About 60% of these women also have migraine at other times of the month, too.
In the same woman, attacks of menstrual migraine may differ from their other attacks in duration, severity, symptoms, and response to treatment. Estrogen itself is not the culprit. Hormonal fluctuations, and especially estrogen withdrawal, are thought to trigger the attack.
Menstrual migraine is generally treated with the same medications that are used for other types of migraine. If a woman’s menstrual migraine is so severe that it doesn’t respond to these medications, hormonal contraceptives might be considered as a treatment.
While birth control pills remain the most popular form of hormonal contraception, hormones can also be administered vaginally, by patch, or injection. The impact of hormonal contraception on migraine varies from woman to woman. Some find they have fewer headaches, while others experience more pain, and some find there’s no effect at all.
Oral contraceptives can trigger a woman’s first migraine attack, especially if she has a family history of migraine. Contraceptives which reduce or eliminate periods are sometimes used to treat severe menstrual migraine. Women with migraine should be careful when choosing a hormonal contraceptive, and weigh the risks and benefits of a particular contraceptive with their doctor.
Migraine sufferers should discuss their pregnancy plans with their doctors. Some migraine medications may impact the ability to conceive and may harm the fetus.
60% of pregnant sufferers find their migraines improve significantly in their first trimester, and more than 75% find they improve or even disappear during the rest of their pregnancy. Unfortunately, this is not the case for everyone. 15% report their migraines worsen during the first trimester, and about 25% notice no change. Usually, sufferers return to their pre-pregnancy migraine patterns after they give birth. Regular nursing may delay the return of migraines.
Migraines often worsen during per menopause, the years before menopause, with intense hormonal fluctuations. But the prevalence of migraine decreases significantly during menopause, when menstruation ends and hormones cease fluctuating. Migraines improve or go away entirely in 67% of sufferers. Women who go through natural menopause often find their migraine symptoms improve dramatically, while women who experience a surgical menopause often suffer more. The effect of estrogen replacement therapy on migraine varies.
The prevalence of migraine drops markedly after age 60 to 7.5% in older women. Few sufferers have their first migraine after age 65. It’s important to consult a doctor to explore the causes of headaches in later life to rule out other medical problems.
Migraine often goes undiagnosed in kids and teens.
In childhood migraine, head pain may be less severe than other symptoms, like unexplained nausea or vomiting, abdominal pain, or dizziness. These non-headache symptoms are referred to as migraine equivalents. Like adults, children may experience migraine with or without aura, a visual disturbance which can occur about an hour prior to the headache. But migraine without aura is more common.
Before a migraine begins, parents may observe changes in their child’s behavior, including loss of appetite, irritability, yawning, food cravings, lethargy, withdrawal, and mood swings. Sensitivity to light, touch, smell, and/or sound is also common. Other indicators may include sleep walking, sleep talking and night terrors. Infant colic and motion sickness may be warning signs of a predisposition to childhood migraine or an early form of it.
The most common migraine triggers in children are inadequate or changed sleep, skipped meals, stress, weather changes, bright lights, loud noises, strong odors, and hormonal fluctuations. Contrary to popular belief, there is little evidence linking specific foods to migraine.
Diagnosing Migraine in Kids and Teens
Diagnosis is made through a patient history, physical exam, and by ruling out other explanations for the symptoms. Sometimes diagnostic tests, such as blood tests, EEG, lumbar puncture, and neuroimaging are also used to assist in the diagnosis. Migraine tends to run in families, so family history of migraine is a risk factor.
A history, preferably conducted with both the child and the parent, should include:
It’s important to explore whether there’s a pattern to the attacks. For example, attacks may occur after a car ride or when the weather changes. Girls may have attacks associated with their menstrual cycle. Parents and kids should keep a joint headache diary to assist the doctor in diagnosis and treatment.