Three times as many women suffer migraines and why they’re worse in a heatwave – iNews

Posted: July 1, 2020 at 1:00 pm

Something doesnt feel quite right. Theres a tightness, a fogginess, a malaise, a pain. Thirty minutes later we might use other words: splitting, pounding, banging. Now its a headache.

This happened to me recently. I was late for a meeting and couldnt find my glasses, and I was very tired. I had watched a dystopian drama the previous night with a glass of wine, and I couldnt get to sleep. Everybody was very understanding when I got there in my hot and bothered state. But after that I seemed to chase my tail all day. By the time I got home at 6pm all I wanted for dinner was a paracetamol sandwich.

Women are known to suffer more headaches than men. In the case of migraines, there are three times as many female sufferers as male ones. To understand why, its useful to know whats happening in our brains when we get a headache.

With all headaches, the pain comes from an increase of blood flow to your brain and the widening of the blood vessels (the cerebrovascular system) that feed it. Blood is toxic to the brain, so that system keeps it neatly separate from the neurons that make your brain produce all of your behaviours. The alarm system for the brain is the stretching of the pain receptors in the blood vessels as they dilate.

The pain makes us stop what we are doing and in some instances, such as in migraine, will incapacitate us until everything is back to normal. Tension can cause headaches, but the headache is caused as much by the stresses of our daily lives as it is by the choices we make under stress. We might sit in the same place for longer and not move around as we are under time pressures, leading to stiff muscles, inflammation and nitric oxide release. We might not drink as much water as we should to replenish that which we are losing to make the coffee, sugary snacks and alcohol we are consuming safe to excrete.

Heat increases stress on the body due to the sheer effort of maintaining a safe body temperature. Your heart rate increases and blood vessels move towards the surface of the skin to help heat escape. This results in sweating, which draws water away from joints, muscles and the brain.

Decreasing water levels in the body cause dehydration and affect the brain. Heat may trigger migraines more frequently in some sufferers.

It is more likely that lifestyle changes relating to hot weather trigger migraines more than heat itself. We sleep less, need to drink more water and lose our appetites.

You should avoid direct sunlight from noon to about 3pm. If you are heading outside, wear a hat which protects your head and neck fully, and wear dark sunglasses. Ensure you drink plenty of water throughout the day. If you find that you are feeling tired and can feel a migraine coming on, lie down in a cool, dark room and place a cold compress on your head such as a flannel.

A few ways to soothe migraines are to place a cold pack or cold flannel on your forehead to try to reduce the pain. Lavender oil has been known to ease migraine or headache pain; drop a bit of oil on tissue and inhale gently. Ginger has also been known to ease symptoms; try adding some to hot water for a home-made ginger tea.

Parvinder Sagoo, simplymedsonline.co.uk/migraine

When this happens, we lose water from the brain, which is an oasis in the body. If the kidneys need more water to dilute our urine, this is one of the places they get it from. If you are dehydrated, your brain shrinks in volume, pulling on the membrane covering it and causing more pain signals. Whats worse, those few glasses of wine you had to destress play with your neurochemistry, which ultimately leads to feelings of anxiety later.

Worst of all, long-term stress makes us unhappy and this can be linked to a dip in serotonin, the happy hormone which controls our mood. Fortunately, chocolate contains tryptophan, which is converted into serotonin in our bodies. Our craving for chocolate in stressful times is often our bodys way to self-medicate. A good laugh helps boost serotonin, too.

A painkiller such as ibuprofen can ease the pain, and paracetamol, particularly in combination with caffeine, is effective against tension headaches.

Although almost everyone has had a tension-type headache, not everyone has experienced a migraine. Migraine has a specific symptom set that means it is recognised as something separate from other classes of headache. In migraine, much has happened in the brain before the pain even starts.

In this prodrome phase, there are warning signs such as drowsiness, food cravings, aversion to light, thirst or blurred vision. All can be linked to altered concentrations of chemicals in the brain, which creates the conditions necessary for the next stage: the sensory disturbance known as an aura.

Not everybody has a conscious perception of an aura but it is thought that the same thing is happening in the brains of those who experience an aura and those who dont. The difference lies in how eloquent your cerebral cortex is.

What is happening in this stage is that a wave of excitation is passing over your brain followed by a wave of inactivity. You might therefore see things that arent there, such as flashing lights and scintillating lines as the wave passes over your visual areas, or experience other disturbances in your touch or smell.

Alterations in chemical balance that these waves cause, however, are the triggers for the pain phase because the waves set up vasoconstriction that the brain knows is dangerous: a lack of blood flow to the brain is as damaging as a bleed. This is corrected by vasodilation that stretches the vessels, which we feel as a throbbing, usually towards the front of the head. The relay system for pain signals in the brainstem and thalamus beneath the cortex is connected to all the other parts of the brain and so makes you feel wobbly, clumsy, sick and, of course, very averse to light.

All of this can knock you flat until the chemical balances can be brought back in line. The whole sorry episode leaves the migraineur exhausted in the postdrome phase, while their neurotransmitters and hormones are rebalancing.

Why are women more likely to suffer from this syndrome than men? In 1939, American physician Herman Selinsky argued that this was because a migraine episode could be seen as an escape for the patient from a bad situation and that harassed housewives were particularly prone.

But we now know it comes down to hormones. It turns out that 70 per cent of female migraineurs experience menstrual migraine. Indeed, oestrogen can play with neuronal excitability in lots of ways and it also interacts with the blood vessels of the brain.

Given that we know how important chemical and hormonal balance is in staving off headache, it is not surprising that those of us who experience monthly fluctuations are particularly at risk for migraine.

The use of external hormones such as oral contraceptives might ease symptoms as they stop the fluctuation of hormones necessary for ovulation, which can affect our mood and cognitive function. In essence, functions that would normally be served by one side of the brain now include both. A lack of normal inhibition between the brains hemispheres can lead to the wave of excitation in migraine and so women are vulnerable to migraine at times in their menstrual cycles.

Serotonin, which controls how much pain signal gets to our brain in addition to controlling our mood, may drop during the second half of the menstrual cycle. This explains why sumatriptan, which acts just like serotonin in the brain, is an effective migraine treatment.

But it also explains chocolate craving during the cycle: the chocolate doesnt cause your migraine, as is often thought. It really is your brain telling your body to self-medicate as the migraine begins, through the tryptophan it contains. Although males and females profess to love chocolate to the same degree, it seems women have more licence to eat it.

Splitting: The Inside Story on Headachesby Amanda Ellison (Green Tree, 16.99) is out now

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Three times as many women suffer migraines and why they're worse in a heatwave - iNews

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