Recent studies suggest that women who suffer from more migraines are more likely to suffer from depression. However, medical professionals are still not sure what causes migraines in the first place.
Check out our migraine masterclass to find out more about a condition that affects one in seven people in the UK.
What is a migraine?
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Why women?
The fact that recent studies suggest women are more likely to suffer from migraine-related depression could well be down to the fact that women appear to have drawn the short straw when it comes to migraines. "Women are more commonly affected by migraines in adulthood but it seems to trouble the sexes equally before puberty," points out migraine specialist Dr Jane Horti.
Migraines and age
Although male migraine sufferers will often find their migraines lessen, women are more likely to suffer from migraines until later in life. "The commonest age for the onset of migraines is the second decade of life," says Dr Jane Horti. "Boys often grow out of it but girls will often have migraines for most of their adult life. It often improves after the menopause but I do have patients in their 80s still having migraines."
How to treat a migraine
Although regular migraine sufferers will know how suddenly one can develop, knowing that a migraine may be on the horizon can be useful when it comes to treating it. "Treating a migraine early can be incredibly useful," says Dr Jane Horti. "Finding a comfortable place to sit and have a rest is important - don't keep pushing yourself. A short break will allow you to function later. Taking some analgesia (such as aspirin or paracetamol) in a soluble form with a drug (such as domperidone) to reverse gastric stasis is important."
Don't suffer on an empty stomach
While tucking into a hearty meal might be the last thing on your mind if you're experiencing a migraine, a quick snack could make a huge difference. "Many people will experience nausea and will vomit with a migraine and this is because the gut will often stop functioning properly," points out Dr Jane Horti. "Reversing this makes you feel better and also allows the analgesia to be absorbed quicker. Having a snack can also help. If this simple treatment does not work for you, GPs can prescribe another drug called a triptan that can often be very effective."
Keep a migraine diary
A diary is one of the most important weapons for those waging war on migraines.
"The most important thing is to identify and then modify triggers for migraine," says Dr Jane Horti. "Keeping a diary can help you do this. Simple lifestyle changes can be extremely effective - adequate hydration, eating regularly to stabilise blood sugar levels, dealing with stress and keeping to a good sleep routine can all help. In many of my patients simple changes in their life (such as eating breakfast before commuting to work or having a small snack before going to bed) really can make a significant difference with their migraines. If lifestyle changes don't help and a patient isn't coping with their migraines they should talk to their GP about possible prevention drugs."
How exercise can help
It's easy to underestimate the importance of exercise when it comes to migraines.
"There's evidence that regular moderate exercise may help migraines," says Dr Jane Horti. "I advise all my patients to regularly exercise. It helps stress and often gives you better quality sleep - both of which are good for migraines. It may also help stabilise blood sugar levels. However, it is important to be careful - you should hydrate adequately and have a small snack before and after exercising. If you don't do this or suddenly start unaccustomed exercise at too high a level you could end up triggering a migraine."
Migraines and stress
You probably won't be surprised that stress is a common migraine trigger, but studies suggest that migraines are just as likely to strike during periods of relaxation.
"Stress is a frequently mentioned migraine trigger factor - either an increase in stress but also when we're relaxing after stressful periods," says Susan Haydon, support services manager at the Migraine Trust. "Some migraine sufferers say that they always get an attack at the weekend or on holiday when they are less stressed than usual. Several studies indicate that tension, fatigue and irritability often precede migraines by a day or more. Stress may possibly lead to a migraine by inducing the state of cortical neuronal hyper-excitability that seems to be present in all migraine sufferers."
Migraine triggers
"While the exact cause is still not entirely understood, migraines are thought to run in families, and are thought to have a genetic component," says Susan Haydon. "To complicate things, there is a difference between the cause of migraine, and what 'triggers' a specific migraine attack. Almost anything can trigger a migraine attack if a person is prone to migraine and sensitive to that trigger."
Migraines and stress - or lack of!
Some of the most common triggers include hunger, eating irregularly, stress, periods of relaxation after stressful periods, bright or flickering lights, changes to routine, or travelling. "Women may notice that they are more likely to experience a migraine attack around the beginning of their menstrual period," says Susan Haydon. "Research suggests that the reason for this is that the level of oestrogen drops just before their period starts, and this can be a migraine trigger factor for some women."
Migraines around the world
Although it's easy to imagine that migraines might be more common in the western world, this isn't actually the case. "The prevalence of migraine is remarkably constant around the world with about 10-12% of the general adult population being affected," says Susan Haydon. "However, some studies in some African and Asian countries have indicated a lower prevalence of migraine in these countries than in Europe and North America."
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