Dec 8, 2019 by Hamza Sheraz.
With migraines affecting one in seven adults – predominantly women – Fiona Sturges asks if there’s a gender pain gap.
Once or twice a month, I get a sensation in my head that signals it’s time to retreat from the world. At first, the arrival of a migraine delivers a gentle throb just above my left eye that combines with mild waves of nausea. As the sick feeling increases, the throb turns into something closer to drilling, like a small, angry creature trying to bore its way out of my skull. My vision becomes fuzzy, as does my sense of spatial awareness. Falling over furniture, Buster Keaton-style, happens a lot. But by far the most intolerable thing is noise. A passing motorbike or a piece of dropped cutlery can feel like a building collapsing on to my head.
Over 20 years of living with migraines, I have discovered that asking a GP for help is akin to going to Bella Italia and requesting white truffle. In my experience, interest among doctors in combating the pain is, if not a rarity, certainly a bonus. “What do you think is the cause?” they ask me, absently, at which point I deliver a list of things that can, but won’t always, trigger an episode. In no particular order, this can include: coffee, alcohol, dark chocolate, LED lighting, flickering computer screens, strong perfume, overwork, too much sleep, not enough sleep, overeating, undereating, anxiety, periods, my mother. Some of these things can be avoided – I haven’t touched alcohol or dark chocolate for years; others, such as periods, LEDs and tricky relatives, not so much. And so painkillers are invariably prescribed, in the hope I’ll be able to vaguely function through an attack. So far, none have touched the sides, and some have made it considerably worse. This is because these treatments come with a list of potential side-effects, one of which is – brilliant, this – headaches.
While doctors tend to stifle a yawn at the mention of migraines, well-meaning friends and colleagues all seem to have solutions, among them craniosacral therapy, massage, acupuncture, yoga, pilates, meditation, mindfulness. I try to be open-minded, but the days of handing over my bank card to someone who reckons I can “om” my way out of a migraine are over. You try being mindful when your skull is being carpet-bombed from the inside. I just want drugs that work.
According to the World Health Organization, migraines affect one in every seven adults, though women suffer from it three times as often as men. This can, in part, be attributed to our fluctuating oestrogen levels, meaning many women experience migraines in the days leading up to their period, though not all are hormone-related. But, even so, the perception endures that the condition is linked to emotion and mental health. In the 19th century, physicians saw migraines in women as a form of hysteria – one labelled it “hysterical headache” – and in the 21st century, some aspects of that view remain.I try to be open-minded, but the days of handing over my bank card to someone who reckons I can 'om' my way out of a migraine are over
Not everyone views migraine negatively. The novelist Siri Hustvedt has written almost fondly of the “supernatural” aura phenomenon that accompanies her episodes, in which she feels parts of her body ballooning and shrinking, Alice In Wonderland-style, and in which showers of stars fall around the edges of her vision. In her essay In Bed, Joan Didion regards hers as “more friend than lodger”, and has learned to revel in the euphoria of convalescence. I can relate to Didion’s experience. There’s something alluring about disappearing into my cocoon of darkness and quiet during a migraine, left alone with my fractured thoughts, and waiting out the storm. The real torture arrives when life demands that I plough on regardless. Stupidly, in the midst of an attack, I tend not to tell people, as I don’t want to appear weak – though it turns out that a grey complexion and vomiting in public bins is a dead giveaway.
This perceived weakness, I believe, is at the heart of why so many of us resign ourselves to a life spent coping with migraines, rather than finding ways to banish it. Women, in particular, are conditioned to believe that distress and pain – be it migraines, period pain, endometriosis, miscarriage, childbirth, menopause, the list goes on – is something we must live with and ideally keep quiet about.
It could by why we seem no closer to understanding the causes of our affliction. Modern studies tend to concentrate on control rather than cure. If it were three times as many men as women that suffered, would the situation be different? Who can say? For now, us migraineurs must blunder on, trying to accommodate the creature in our skulls and quietly asking people to keep the bloody noise down.