At times, Mary-Anne McDermott’s crippling migraine pain gets so bad that it invades almost all her senses. “I used to mostly suffer from light sensitivity. Now it’s light, sound, smell and I become very nauseous which on occasion leads to vomiting,” says McDermott, a patient of the Wasser Pain Management Centre at Mount Sinai Hospital. “I now have six to seven migraines a month, most lasting between three to five days.”
McDermott has suffered from migraine pain since elementary school. Now 30, she has endured a significant increase in the pain she experiences. After a recent visit to the emergency room following five straight days of pain, McDermott decided it was time to see a headache specialist at Mount Sinai Hospital.
The Wasser Pain Management Centre sees 800 to 1,000 new patients each year for everything from nerve pain to pelvic pain. Women make up about 70 per cent of its patients.
Migraine headaches, which affect approximately three times more women than men, can be devastating and lead to disability, dysfunction, missed work or even the loss of a job. Migraine is one of the most common types of pain and yet, physicians can only speculate why women are disproportionately affected.
“At present, we don’t know exactly why migraines are more prevalent in women than in men,” says Dr. Allan Gordon, Director of the Wasser Pain Management Centre and a specialist in the treatment and management of migraine pain. “A number of studies found that pre-pubescent males and females experience a similar rate of migraines, leading to the conclusion that hormones are a significant factor in the cause of the pain.”
During pregnancy, for example, hormonal changes can affect the frequency and severity of migraine headaches in women. About two-thirds of migraine sufferers endure the same level of pain or worse during their pregnancy, while one-third will experience decreased pain or none at all. Like the hormonal ups and downs however, these changes are temporary. For those with reduced pain, migraine symptoms almost always return after pregnancy.
Treatment options for women considering pregnancy are severely reduced. “Many of the pharmacological treatments available for migraines should not be used during pregnancy or for anyone contemplating pregnancy as they may affect fertility and the health of the fetus,” explains Dr. Gordon. “Men do not have to worry about fertility issues and the impact of medication during conception, pregnancy or breastfeeding.”
While women may face more obstacles than men in managing migraine pain, the Wasser Pain Management Centre offers a variety of pharmacological and alternative treatment options such as relaxation therapy, mindfulness and biofeedback. “In managing patients it’s important to address a person’s overall health,” Dr. Gordon says, highlighting the centre’s focus on mental, emotional and physical health.
Dr. Gordon started McDermott on new medication in January 2009 that has helped reduce the number of episodes. For now, this treatment is working well for McDermott and she finds encouragement in Dr. Gordon’s successes. “I’ve heard from many other patients that he is very good and I’m feeling hopeful about my situation,” she says.