Migraines are three times more common among young women than men due to hormonal fluctuations. Stress and sleep also impact. The new therapies available
According to the World Health Organization themigraine it represents one of the most debilitating diseases with important repercussions on the personal, social, working and emotional lives of patients who suffer from it with important costs that countries have to face (from 18 to 27 billion in Europe). In the world About 1 billion people suffer from migraines (12% of the world population) e in Italy alone the disorder affects six million citizenswith a clear predilection for lyouth-adult age and women.
Migraine woman
One of the main types of headache is migraine and one of the most common causes of temporary disability among women aged between 15 and 49. L'migraine characterized by a pain that often affects half the head starting from the temple or forehead. The pain is very intense and throbbing; often accompanies it nausea, vomiting, discomfort with light and sounds with episodes that can last from a few hours up to three days. Before puberty, boys and girls are equally likely to suffer from migraines, but once they reach development, migraines become much more common among women. Women have a chance
three times more likely to suffer from migraines than men
and this type of headache usually hits women hardest in their 30s and 40s, a particularly busy period of life with work, family, children and the consequences of days lost due to debilitating pain are important he says Gennaro Bussone, neurologist, founder of the Headache Center of the Besta hospital in Milan. Female migraine – he adds – is the reason why it affects women more who are generally very stressed and pressured by family and work commitments and lead a life with their foot always pressed on the accelerator. the brain that “warns” the woman that she has exceeded the limits with the headache, which becomes a symptom. A study from a few years ago found that the Italian woman with migrainecompared to its European colleagues, she tends more than anyone to go to work the same even if he is not well. Women also generally have greater difficulty sleeping
compared to men and the tiredness can cause headaches. However, to look for in the female sexual hormonesand particularly in theirs fluctuationthe leading cause of migraines in women.
The role of estrogen in migraine
Numerous scientific studies they demonstrated that estrogens play an important role in the development of migraine. 60-70 percent of patients have attacks related to different moments of the cycle, especially right before or during menstruation, when estrogen levels drop. The main cause is the periodic, sharp drop in estrogen in this phase which, in women who are very sensitive to hormonal fluctuations, can trigger pain explains Bussone, who was also president of the Italian Neurological Association for Headache Research. Research has not yet clarified why estrogen fluctuations trigger migraines; However, the female hormone performs important activities within the brain (such as improving cerebral blood flow, neuronal connection and the release of neurotransmitters), so hormonal changes could trigger a series of events that then culminate in migraines. Some women may experience headache even during pregnancywhen we witness a drastic change in hormonal structure; others instead experience a decline in attacks. There menopause
for many women it is associated with a improvement of migraine because hormonal fluctuations disappear, but for a far from residual number the end of the menstrual cycle becomes a trigger for pain precisely because there is a drastic change in the hormonal structure. In some women the use of contraceptive pill it can lead to an improvement in migraine, in others the pill (especially old generation) can be worsening. The answersObviously, there are a lot of them subjective and every patient can have it different triggers of headache attacks: from changing weather to the glass of wine
from the lack of sleep to the abuse of caffeinegive herccess of physical activity at the stress. Generally the “triggers” are the same ones that trigger tension headache, another type of headache, the most widespread.
Tension headache
In addition to migraines, women are about 1.5 times more likely of men to suffer from
tension headache
or the classic headache that everyone experiences sooner or later, characterized by a dull pain that affects in a widespread way, of mild-medium intensityand therefore bearable but what it does not allow you to carry out normal daily activities as you would like. It is not yet clear why tension headaches are more common in women, but it is stress and anxiety could play a role, in addition to subjective triggers. Some studies suggest that this type of headache is more frequent in women in the days close to the menstrual cycle and hormones could also be involved in this case. Other work, however, does not provide evidence that hormones are to blame. Tension headache is the somatized mirror of an emotional state – says Bussone – and to limit migraine and headache attacks, when you are not in the acute phase of pain, you can try to experiment relaxation techniquesas the mindfulness or the pilates. Physical activity can prevent and even cure some headaches, in particular tension headaches which are favored by an unhealthy lifestyle. They are instead
avoid excessive or prolonged efforts
which can be counterproductive and lead to headaches.
The therapies
If they occur more than 5-6 episodes of headaches per month and each episode lasts 1-2 days it's not enough anymoreanalgesicbut one is needed specific therapy turning to a Headache Center suggests the neurologist. Today they exist new drugs for prevention therapy which reduce the frequency and severity of attacks and they are more effective than traditional therapies, in particular with regards to the side effects which push 8 out of 10 patients to abandon therapy. Headache Centers have available monoclonal antibodies directed against the CGRP (peptide related to the calcitonin gene), protagonist of migraine pain. These treatments are well tolerated, safe and effective: they halve the monthly migraine days in 70% of patients, also reducing the intensity of the crisis. In some patients (10-15%) migraine can be significantly reduced, radically changing the quality of their life, as emerged from the latest National Congress of the Italian Society of Neurology (SIN) which took place last October in Naples. It's about very expensive drugs, for now intended only for patients who have failed three previous treatments or who cannot follow traditional therapies or who suffer from chronic migraines. Also there botulinum toxin has been shown to be effective in the prevention of chronic migraine, however the protocol requires periodic administration at authorized headache centres. New drugs are also arriving for migraine attacks such as ditani (an advancement of triptans), which act on the serotonin receptor and i gepanti, which always target the CGRP molecule. Some of these drugs can be used as preventive therapy.
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December 11, 2023 (changed December 11, 2023 | 07:55)
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