Migraine attacks commonly involve a painful throbbing pain – most times on one side of the head, sometimes both, and can have far-reaching consequences across all areas of our lives. 

According to Sunway Medical Centre consultant neurologist Dr Raymond Tan, migraine as an incapacitating neurological disorder comes with wide range of symptoms including blurred vision, nausea and vomiting, sensitivity to lights, noises, and scents, and for some, aura or focal neurologic symptoms.  

A migraine attack can last between 4 to 72 hours in duration, he added. 

Migraine and the gender divide 

Migraines can afflict men, women and children but it is not an equal opportunity disorder. Of those who suffer chronic crippling migraine attacks, the vast majority are women.  

According to the Office on Women’s Health, migraine is three times more common in women than in men and is the fourth leading cause of disability in women. 

“This difference between men and women is largely due to a specific hormonal change, namely estrogen that helps regulate the female reproductive system and controls chemicals in the brain that impact the sensation of pain,” explained Sunway Medical Centre consultant obstetrician and gynaecologist Dr Sharmina Kamal. 

“Therefore, a drop in estrogen levels can contribute to the development of chronic headaches or migraines.” 

In childhood, migraines are more prevalent in males. However, once the influence of estrogen begins, that is when the prevalence starts to rise in females, contributing to more common, longer-lasting headaches in women between the ages of 20 and 45. 

Along with hormonal changes, Dr Sharmina highlights that there are other factors and events that could trigger a migraine, which include lack of sleep or too much sleep, skipped meals, weather changes, alcohol and caffeine.  

Coupled with stress, migraines have become part and parcel of many women’s day-to-day lives.  

Heading off the pain 

The good news is that migraine is a modifiable disorder and there is hope for seeking relief through very simple things.  

“The best thing to do at the start of a migraine is to stop your activity and get some rest, preferably in a quie and dim lit room or area,” Dr Tan suggested.

“Taking a simple analgesic like Paracetamol at the start of the migraine often helps to limit the severity. Application of topical menthol may also lessen the intensity of acute migraines, although this is best avoided in women who are pregnant or breastfeeding.” 

Medication is a proven way to both treat and prevent migraines. However, medication is only part of the story.  

Combining therapy or medication with behavioural measures and lifestyle that promote overall good health can often be the most effective way to handle migraine attacks. 

For example, maintaining a healthy lifestyle includes nutritious foods, adequate hydration, frequent exercise, and proper sleep. You can also speak to your physician about daily vitamins or supplements, such as vitamin B or magnesium. 

Red flags and signs that it’s more than “just a migraine”  

Migraines are a real source of pain, but most of the time, they are not signs that one has a serious medical problem. However, it is worth speaking to your doctor when you have new symptoms that are more severe than normal. 

Know your migraine symptoms – what is normal for you and what is not, and when you need emergency help. 

The following are some signs that you should get medical help right away: 

• Uncontrollable vomiting; 
• Loss of consciousness; 
• Seizures or convulsions; 
• Blurred vision or other vision changes; and 
• Loss of balance or coordination 

While migraine attacks are not a threat to life and limb, when it happens, there are situations where complications can occur. 

“Occasionally, the migraine attacks persist for more than 72 hours and become debilitating and resistant to conventional treatment,” Dr Tan remarked.  

“And in cases associated with persistent vomiting, this could lead to potential dehydration and its associated problems, which could require hospitalisation with intravenous fluids and medications.”  

According to Dr Tan, young women who experience migraines with aura, especially those who smoke or use oral contraceptives, have an increased incidence of stroke and, in some cases, can cause seizures.   

With that, it is advisable for women at risk to avoid smoking and choose other forms of contraception, if possible.