Migraine in women: symptoms and treatment

Migraine is a neurological disease that is a headache with special characteristics. Women suffer from this ailment more often than men, which is connected with the hormonal background. A special role in the development of migraine in women is played by periods of menstruation, pregnancy and childbirth. This type of headache causes disability due to its intensity. In the treatment of migraine in women, there are various ways that are divided into two groups: those that use in the period of seizures, and those that are used to prevent the onset of a headache. From this article you will learn about the symptoms and ways of treating migraine in women.

What is a migraine?

Migraine is a paroxysmal headache, which is localized most often in one half of the head, mainly in the ophthalmic-frontotemporal region, is of a pulsating nature. The pain is significant, it can be accompanied by nausea and vomiting. During an attack, any sounds and light seem unbearable. Attacks of a headache last on the average from 2 hours up to 3 days, exhausting the patient. A single occurrence of such an attack of a headache does not mean that a person has a migraine. According to world statistics, up to 80% of the world's population have suffered a migraine headache attack at least once in their life. In order for a doctor to diagnose a migraine, it is necessary that typical seizures are repeated several times.

It can be said that migraine is a predominantly female problem, because this disease is much more common in women (although men can suffer from this ailment). The disease affects women of young and able-bodied age from 20 to 50 years. This fact is closely related to the hormonal activity of young women. Climax can lead to the spontaneous disappearance of migraine pain.

What is the cause of migraine in women?

There is as yet no clear and unequivocal answer to this question. Some women have a hereditary predisposition to migraines, such situations account for up to 70%. The remaining 30% become the first in the genus, in which migraine is detected.

It is believed that migraine is a consequence of a consistent change in the diameter of the extra- and intracranial vessels. Initially, there arises spasm of the arteries and deterioration of the blood supply to individual parts of the brain, which is then replaced by the expansion of the vessels, overgrowth of their walls. Before the attack there is an increase in the concentration of a special substance, serotonin, in the tissues of the brain. Serotonin causes a short-term vasospasm. In order to split the excess of serotonin, the body throws out other substances, the so-called neuropeptides. Among them, an important role is played by substance P, neurokinin A, which have the ability to dilate blood vessels. Once the concentration of serotonin comes back to normal, a migraine attack ends.

Factors that increase the risk of migraine:

• sedentary lifestyle;
• living in a city, especially large (environmental pollution, intensity of life play a role);
• presence of bronchial asthma, arterial hypertension, diseases of the gastrointestinal tract.

Provoking factors:

• change of weather (changes in atmospheric pressure, strong wind and snow, heat);
• emotional stress;
• excess of caffeine (strong coffee, tea, energy drinks);
• eating a large amount of preservatives and some food additives (taste enhancer glutamate sodium, nitrites and so on);
• violation of sleep (both excess sleep and lack);
• physical overwork;
• a large gap between meals (hunger);
• consumption of individual products: chocolate, citrus fruits, nuts, aged cheese, cocoa, tomatoes, eggs, fatty foods, alcohol (especially wine and beer);
• smoking;
• stay in the conditions of flashing light and sparkling lights, too loud music (visiting nightclubs);
• exacerbation of existing chronic diseases;
• taking certain medicines (eg, Nitroglycerin, Ranitidine);
• vestibular irritations (swings, rides, trips in the car, airplane, sea voyages);
• hormonal fluctuations (the period of menstruation and ovulation, the intake of hormonal contraceptives, hormone replacement therapy).

Symptoms of migraine

Headache with migraine appears gradually. There is a feeling of discomfort, which grows into pain. The intensity of pain increases, reaching a moderate or severe degree. The time of development of the headache ranges from 30 minutes to 1 hour. Having reached the maximum of its development, the pain lasts an average of several hours (from 2 hours to 3 days). The pain is exhausting, exhausting the patient.

Most often, the headache with migraine is one-sided. However, as the disease progresses, alternation of sides or bilateral localization becomes characteristic. The long existence of migraine on the one hand requires careful examination, as it can be a sign of another disease.

Usually the pain is pulsating, like a beating character, but it can also be blunt, pressing, bursting, bursting. It intensifies with minor movements, turns of the head, even an attempt to look.

Pain begins with the temporal region, passes over to the eye and forehead. It happens that painful sensations immediately appear in one half of the head.

During a migraine attack, almost always a woman feels nauseous, sometimes worse before vomiting. Characteristic intolerance of odors, which in themselves provoke nausea and vomiting. Naturally, during an attack of a headache about any intake of food can not be even a speech.

In addition, migraine attacks are also accompanied by light and dental phobia. This is due to the fact that these stimuli increase the headache. It is possible such a migraine, in which there is only nausea and vomiting or just light and sound.

All these characteristics of headaches with migraines lead to the fact that a woman wants to retire, isolating herself from everything and everyone. Therefore, often during an attack, women go to bed in a dark room, closing the doors and windows beforehand.

Sometimes the headache is accompanied by drowsiness. It's good if you get to sleep with a migraine, because, as a rule, after a dream, the headache goes away.

The attack of a headache with migraine can be accompanied by various vegetative manifestations:

• chills;
• increased body temperature;
• a feeling of heat;
• pallor of the skin;
• sweating;
• palpitation;
• dry mouth;
• sensation of suffocation, a feeling of lack of air;
• repeated yawning;
• pain in the epigastric region;
• disorder of stool (diarrhea);
• copious urination;
• fainting.

These symptoms do not necessarily occur with every attack of a headache, can have a different degree of severity. It should be borne in mind that not all vegetative manifestations occur at once, but only one or two.

The frequency of migraine attacks is different. On average, women suffer it 1-2 times a month. In severe cases, seizures recur after a few days, in the lungs - a similar headache worries 1-2 times a year. If the migraine recurs 15 or more times a month for 3 consecutive months, then it is already a chronic migraine.

Sometimes migraine attacks are preceded by so-called prodromal phenomena. They occur the day before or a few hours before the attack. To such attributes carry:

• deterioration of mood, irritability;
• overactive or, conversely, sluggish motor behavior;
• unreasonable fatigue or increased intellectual activity;
• slow thinking, reduced concentration of attention.

Naturally, these are very nonspecific signs, but patients with migraine due to the recurrence of seizures "learn" to notice such changes and associate them with the subsequent development of a headache. For a person suffering from migraine, it is important to anticipate an attack, since taking certain medicines can prevent it.

After the end of the migraine attack, women often have post-attack symptoms in the form of a general weakness, feelings of exhaustion, physical fatigue, muscle pain, inability to concentrate. These symptoms can last from 1 hour to several days. Usually, there is a directly proportional relationship between the duration of the post-attack period and the severity of the headache and the time of its existence.

Types of migraine

There are two types of migraines: simple (migraine without aura) and classical (migraine with aura). A simple migraine corresponds to the above characteristics and accounts for 80% of all migraine cases. Migraine with aura on clinical manifestations corresponds to simple, but still accompanied by the development of aura.

What is an aura? Aura are neurological symptoms that occur immediately before a headache attack. Do not confuse the aura with the prodromal symptoms described above. These are completely different signs.

Aura occurs 5-60 minutes before the onset of a headache. No more. That is, between the aura and the development of the headache can not pass more than 60 minutes. If there is more than one symptom to the aura, then the duration of the aura increases proportionally and can be more than 60 minutes. The symptoms of the aura arise and then completely disappear. Each patient has the same aura. After several attacks of headache with aura, a person can clearly follow the pattern: the symptoms of the aura - after a short interval, a migraine attack. Taking medication when an aura occurs can prevent a headache.

What is the aura? Its following varieties are known:

• ophthalmic: when a woman sees flashes, zigzags, lightning, dots and other visual images before her eyes. Possible loss of the field of view or part of it;
• retinal: sudden loss of vision to one or both eyes (or loss of a part of the vision in the center);
• ophthalmoplegic: violation of eye movements, eyelid drooping (ptosis), sensation of doubling of objects (which is associated with a violation of contraction of the internal muscles of the eye);
• Sensitive: numbness, crawling sensation, tingling, burning sensations that occur in the fingers of one hand, and then spread to the entire hand, tongue and half of the face;
• motor: muscle weakness down to impossibility to move limbs of one half of the body;
• speech: blurred and blurred speech, the inability to pronounce anything, the lack of understanding of speech;
• vestibular: from slight to severe dizziness with a fall;
• basilar: a special form, observed in girls 10-15 years. It appears as follows: a bright light appears in front of the eyes, followed by a short-term loss of vision at a few minutes, dizziness, tinnitus, blurred speech, sensitive disorders in the limbs and tongue. In 30% of cases, all these symptoms are accompanied by loss of consciousness;
• panic, or vegetative: when the aura is signs of panic attack (fear, anxiety, palpitations, difficulty breathing, chills).

There are times when the headache does not develop after the aura. Then they talk about a migraine aura without a headache.

There is a kind of migraine with an acute aura, when the headache develops immediately after the aura (less than 5 minutes) or simultaneously with it.

Among all types of migraine, women are given one more form: a menstrual (catamenial) migraine. It occurs only during menstruation, in other conditions of attacks of a headache it is not observed. The occurrence of menstrual migraine is associated with a sharp decrease in the concentration of estrogens just before critical days and in the first few days of menstruation.

Treatment of migraine in women

Migraine is a very whimsical disease, if we talk about the methods of treatment. This means that not all women with this diagnosis can be helped by the same drug. In some cases, the doctor can immediately choose an effective treatment, in others - unfortunately, only by trial and error can find a tool that allows you to get rid of the disease. But do not despair: in the fight against migraine you can come out victorious.

In general, the treatment of migraine is divided into two stages: treatment of attacks and prevention of their occurrence. If the treatment of seizures is needed by all migraine patients without exception, only about 10% of patients are indicated for prophylactic treatment. These 10% are those women whose migraine attacks occur more than 2 times a month and lead to a significant decrease in working capacity and quality of life.

First of all, a woman with such a diagnosis should reconsider her way of life. This means that it is necessary to minimize all situations that can provoke a headache attack. That is, to observe the regime of work and rest (including sleep), to limit the use of certain products (citrus fruits, nuts, beer, red wine, coffee and everything listed above), quit smoking, avoid being in places with loud music and blinking bright light, lead a healthy lifestyle. These simple, at first glance, measures contribute, at least, to a decrease in the frequency of attacks of headache.

If a clear connection with the intake of hormonal contraceptives is established, it is recommended to choose another method of protection from unwanted pregnancy.

All drugs used to eliminate migraine attacks are divided into two groups: preparations of nonspecific (simply anesthetizing) the action and the specific (stopping the development of the migraine attack).

To nonspecific medications are:

• simple and combined analgesics: Paracetamol, Acetylsalicylic acid, Ascofen-P, Sedalgin, Pentalgin, Spasmoveralgin and the like preparations;
• non-steroidal anti-inflammatory drugs: Naproxen, Diclofenac, Ibuprofen, Indomethacin.

The key to the effectiveness of these drugs is their early use, that is, at the very beginning of the attack. When the headache has already reached its peak, their use is not accompanied by analgesic effect. In view of the presence of nausea or vomiting at the time of an attack, it is recommended to combine the intake of these drugs with antiemetic drugs (Cerucal, Metoclopramide, Domperidone). A number of drugs are issued in the form of rectal suppositories, which allows to avoid provocation of vomiting during the medication.

Specific medicinal products:

• ergot preparations (Ergotamine, Dihydroergotamine, Digigergot) and combined preparations with its extract (Nomigren, Kofetamin, Kofergot, Migrex);
• serotonin agonists: Sumatriptan (Imigran), Zolmitriptan (Zomig), Naratriptan (Naramig).

The action of ergot preparations is based on the effect on the smooth muscles of the cerebral vessels: the vessels narrow (and the expansion phase does not occur, which causes migraine pain). In addition, ergot preparations have antiserotonin activity. Produced in the form of variousmedicinal forms that allow the use of drugs inside, subcutaneously, intramuscularly, intravenously and even intranasally (Digidergot).

Serotonin agonists, to date, are considered the most effective drugs in the fight against migraine attacks. They act on special receptors in the walls of the vessels, not allowing the latter to expand. The drugs are effective only in cases of migraine, so they are not used for other types of headache.

In the interictal period, to prevent episodes of headache (that is, for prophylactic purposes) use:

• antagonists of serotonin (Sandomigran, Metisergid);
• β-adrenoblockers (Anaprilin, Atenolol, Nadolol, Lopresol);
• antidepressants (Amitriptyline, Prozac, Sertraline, Paroxetine, Mianserin);
• calcium channel blockers (Verapamil, Nimodipine);
• anticonvulsants (gabapentin, sodium valproate, finlepsin, topiramate);
• non-steroidal anti-inflammatory drugs (Naproxen, Ibuprofen, Indomethacin).

These drugs are prescribed for a long time, for several months. They are not effective in a single admission during a migraine attack (except non-steroidal anti-inflammatory drugs). After several months of admission, the change in the frequency of migraine attacks, their intensity, the duration of the post-attack period and the impact on work capacity are assessed. It is not always possible to select an effective drug on the first attempt.

In addition to drug treatment for migraine should be used acupuncture, rational psychotherapy, auto-training, percutaneous electroneurostimulation, biofeedback method. These non-drug methods in most cases have a beneficial effect on the course of the disease, allow reduce the number of medicines used, and in some cases even dispense with them.

It should be borne in mind that the above are general principles for the treatment of migraine in women. Of course, not all drugs and methods of non-drug treatment are used in one patient. Selection of drugs should be done only by a doctor, taking into account all the individual characteristics of a particular woman.

Thus, migraine is a common problem of a modern woman. This disease brings a lot of suffering and disrupts the habitual way of life, causes disability. To get rid of migraine attacks, you need a comprehensive treatment with individual tactics of the patient. And this can be provided only by a competent specialist, which should be addressed in the event of any type of headache.

D. Ms., director of the headache center Elena Lebedeva talks about migraine and its main signs: