Does migraine attack frequency change over time for women?
Migraine changes over time. Attacks can become more frequent in correlation with age and stage of life. Knowing why that is and what to expect can be helpful in managing the disease over the course of a lifetime.
“It does change. You could be about 12 to 13 years old, and since the majority of [people with migraine], as you know, are female, about 75% are punitively thought to be related to hormonal fluctuations, etc. During menarche, you could start to have headaches once in a while. Then over a few years, you go to college, and you have a few headaches, but you go out to parties, and you're OK — you have a bit of a headache the next day, but you get through it. You're able to drink wine probably some occasions, not other occasions. Then you get married, maybe not married, or have a partner, a friend, or whatever. Then around 35 to 39 it starts to change, not into intermittent migraine but the daily or near daily headache. Even the ones that say, ‘I've got two headaches a week.’ You ask them, ‘In the background?’ and they say, ‘Oh yes, but I have this continuous dull headache in the background.’ Around 35 to 39, they can't even walk by a bottle of wine because it's liable to give them a headache. Then as the chronification process continues, it goes all the way up, for instance, to menopause, 50 to plus or minus two years, either way … Perimenopausal headache can get very bad for some women because hormones don't drop from a high level to zero, they fluctuate down. So if it fluctuates through wide ranges, the headache can fluctuate as well. How do other women, on the other hand, tend to have no headache because it goes away? In fact, a poor man's genetic test has said, ‘Your mother has migraine?’ ‘Yes she did.’ ‘What happened?’ ‘Well when she became menopausal it went away.’ ‘Oh, that's good news. Guess what? You have hope.’ "
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Allan Purdy, MD
Professor of Neurology
Dalhousie University, Canada
Dr. Allan Purdy is a neurologist and a professor at Dalhousie University in Nova Scotia, Canada. Dr. Purdy is currently President of the American Headache Society. He has also served as president of the Canadian Headache Society and on the Board of Directors for the International Headache Society.
Dr. Purdy is regarded as one of the most gifted teachers in the field, developing educational programs for physicians around the world who care for patients with headache diseases. In addition to his research and education work, Dr. Purdy continues to see headache patients in his Canadian clinic on a part-time basis.