I just arrived in Los Angeles for the American Headache Society’s annual scientific meeting. It’s been a rough month, so I’m not sure how much of the conference I’ll get to attend, but I’m eager for whatever I’ll get to learn. Tons of research will be presented at the meeting, but one study in particular is more frightening than exciting:
A study of 3,606 women between the ages of 35 and 65 found that women who were in the transition to menopause or were already in menopause had more frequent migraine attacks than women who hadn’t begun menopause. In the study, about a third of the women hadn’t yet hit menopause (premenopausal), a third were in the transition to menopause (peri-menopausal) and a third had already entered menopause.
Only 8% of premenopausal women had 10 or more migraine attacks per month. Of women who were in the transition to menopause or already in menopause, 12% had 10 or more attacks a month. Researchers concluded that the peri-menopausal and menopausal women were 50% to 60% more likely to have frequent migraine attacks than pre-menopausal women.
Hormonal changes, particularly the drop in estrogen in peri-menopause and menopause, are thought to be responsible for this disparity.
I’d bet at least 99% of women have had a health care provider tell them to expect a decrease in their migraine frequency menopause. Many of us have even been told the migraine attacks will stop completely. This research raises serious doubts about the migraine nirvana we may have thought awaited us.
In response to complaints about the women and shopping ad, Excedrin Migraine has replaced that “fact” on Migraine.com. The new ad says “70% to 80% of people who get migraines have a family history of the disorder.” Thanks for all your comments. Please stop by Excedrin Migraine’s Facebook and Twitter pages to thank them.
Researchers have found a fascinating connection between migraine, depression and childhood abuse in women. I didn’t want to miss any important details, so the American Academy of Neurology‘s press release follows. (Emphasis added.)
Depression in Women with Migraine Linked to Childhood Abuse
Childhood abuse is more common in women with migraine who suffer depression than in women with migraine alone, according to a study published in the September 4, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology.
“This study confirms adverse experiences, particularly childhood abuse, predispose women to health problems later in life, possibly by altering neurobiological systems,” said study author Gretchen Tietjen, MD, with the University of Toledo-Health Science Campus and a member of the American Academy of Neurology.
Researchers surveyed 949 women with migraine about their history of abuse, depression and headache characteristics. Forty percent of the women had chronic headache, more than 15 headaches a month, and 72 percent reported very severe headache-related disability. Physical or sexual abuse was reported in 38 percent of the women and 12 percent reported both physical and sexual abuse in the past. These results for abuse are similar to what’s been reported in the general population.
The association between migraine and depression is well established, but the mechanism is uncertain. The study found women with migraine who had major depression were twice as likely as those with migraine alone to report being sexually abused as a child. If the abuse continued past age 12, the women with migraine were five times more likely to report depression.
“The finding that a variety of somatic symptoms were also more common in people with migraine who had a history of abuse suggests that childhood maltreatment may lead to a spectrum of disorders, which have been linked to serotonin dysfunction,” said Tietjen.
“Our findings contribute to the mounting data that show abuse in childhood has a powerful effect on adult health disorders and the effect intensifies when abuse lasts a long time or continues into adulthood,” said Tietjen. “The findings also support research suggesting that sexual abuse may have more impact on health than physical abuse and that childhood sexual abuse victims, in particular, are more likely to be adversely affected.”
The study also found women with depression and migraine were twice as likely to report multiple types of abuse as a child compared to those without depression, including physical abuse, fear for life, and being in a home with an adult who abused alcohol or drugs.
“Despite the high prevalence of abuse and the increased health costs associated with it, few physicians routinely ask migraine patients about abuse history,” said Tietjen. “By questioning women about their abuse history we’ll be able to better identify those women with migraine at increased risk for depression.”
Three times as many women have migraine as do men. That translates to 18% to 25% of women worldwide. A new study shows that this discrepancy might be because women’s brains are faster to activate the cascading waves of activity thought to cause migraine pain and other migraine symptoms.
The strength of the stimulus required to trigger these waves of activity, called cortical spreading depression (CSD), was two to three times higher for men than for women. This excitability indicates that women’s propensity toward migraine is linked to more than just menstrual cycle.
I have the mental ability of a three-year-old today. See A Woman’s Brain Wired for More Migraines? from CBS/WebMD and Why Women Get More Migraines Than Men, a UCLA press release, for details.
Why Do Women Get More Migraines Than Men? is the topic of tonight’s HealthTalk-hosted webcast. Headache specialists Christina Peterson and Dawn Marcus will discuss this sex disparity and treatments that are particularly helpful for women.
Listener questions will be answered, but you have to register in advance to submit a question (I have no idea how late they’ll will take questions). Registration is not required to listen to the program.
The broadcast starts at 7 p.m. EST (4 p.m. PST). Starting about 10 minutes before the webcast, go to the program’s description page and look for a link that says “Join the Program.”
Sorry for the late notice!