8. What lifestyle changes can a woman make to decrease chances of getting migraines?
We know that stress, poor sleep, the wrong diet, and a lack of exercise can contribute to migraine frequency. I encourage my patients to consider a few lifestyle adaptations, including:
• Getting better sleep: Many migraine attacks happen early in the morning, which may be because of poor sleep (quantity or quality).[xiv] If I have a patient who is waking up in the morning with a headache, sleep issues might be a cause, and I might refer him or her to a sleep specialist for further evaluation. I typically see that if my patients get a good night’s sleep, they may have fewer migraines.
• Managing stress: If it’s discovered that stress is affecting my patient’s symptoms, I recommend regular participation in whatever form of relaxation they enjoy: short walks, listening to calming music, meditation or yoga, guided breathing and biofeedback exercises (there are many smartphone apps available) can be particularly helpful at any time, in any setting.[xiii]
• Eating regularly and avoiding food triggers: The fuel we put in our bodies is as important as regular pit-stops to refuel a car. Skipping meals can cause a drop in blood sugar, which makes the body work harder and can make us more prone to a migraine attack.[xv] Foods high in sugars and simple carbohydrates can cause a quick drop in useable energy, too, so I advise avoiding those kinds of foods. Being aware of and avoiding specific food triggers can be a really important way to minimize attacks.
• Exercising: Recent studies have shown that regular aerobic exercise has a direct effect on migraine frequency: it reduces them.[xvi] This can be a tough-sell to someone whose symptoms are, by definition, worse with physical activity, but if I can get patients on track with regular physical exercise between attacks, I feel confident they’ll have fewer attacks. Exercise causes the body to release endorphins, which act as natural painkillers and anti-depressant chemicals, making it an effective way to control other factors that may influence migraine symptoms.
• Keep a migraine diary: The only way to identify what might influence your migraines is to keep track of your symptoms with a migraine diary. Whether they’re using an app on a smartphone or pencil and a pocket calendar, I encourage my patients to write down when their migraines occur, what the circumstances were at the time they occurred, how they treated them, if the treatment worked, etc. Together, we can identify possible triggers and appropriate therapies.
9. How can repeated migraines affect a woman’s life?
Migraines can affect every aspect of a woman’s life, but because there may be no outward signs of this condition, there’s often a lack of understanding among family and co-workers about just how debilitating a migraine attack can be. The most important thing to remember is that the more episodic migraine (less than 15 headache days per month) goes untreated, the higher the risk for developing chronic migraine (15 or more headache days per month).[xvii] Prompt diagnosis and appropriate treatment is key.
10. What are the treatment options available and how do they work?
If you are experiencing migraines, there are several treatment options that may be right for you. It’s important to remember different treatments work differently for different people. One prescription medication that may provide relief to some acute migraine sufferers is TREXIMET® (sumatriptan/naproxen sodium), which contains two medicines that are designed to provide fast and continued relief from migraines. Please note, there are significant safety concerns that may occur with TREXIMET, such as serious cardiac and gastrointestinal events, so you should discuss your options and concerns with your doctor. [xviii]
Here is a summary of Important Safety Information about TREXIMET. The complete prescribing information is available online.
Prescription TREXIMET® is used to treat acute migraine headaches with or without aura in patients 12 years of age and older.
TREXIMET® is not used to treat other types of headaches such as hemiplegic or basilar migraines. TREXIMET® is not used to prevent or decrease the number of migraine headaches you have. It is not known if TREXIMET® is safe and effective to treat cluster headaches.
IMPORTANT SAFETY INFORMATION
TREXIMET® may increase your chance of a heart attack or stroke that can lead to death. Your chance of a heart attack or stroke increases with longer use of NSAID medicines or if you have heart disease or risk factors for heart disease.
Serious allergic or skin reactions, or stomach and intestine problems such as bleeding and ulcers, can occur without warning and may cause death. Risk of stomach and intestinal problems increases in the elderly.
Do not take TREXIMET® if you have heart problems, history of heart problems, or have ever had heart bypass surgery; had a stroke, TIAs, or problems with your blood circulation; hemiplegic migraines or basilar migraines; narrowing of blood vessels to your legs and arms, stomach, or kidneys; uncontrolled blood pressure; an allergy to aspirin, NSAIDs, sumatriptan or any of the ingredients in TREXIMET®; taken any medicines in the last 24 hours that are triptans or contain ergotamine; taken an MAOI antidepressant within the last 2 weeks; during third trimester of pregnancy; or liver problems. TREXIMET® should never be used if you have ever had a heart surgery called a coronary artery bypass graft (CABG).
Before you take TREXIMET®, tell your healthcare provider about all of your medical conditions including if you have risk factors for heart disease like high blood pressure, high cholesterol, diabetes, smoking, obesity, and heart problems or a family history of heart problems or stroke; kidney problems; liver problems; history of epilepsy or seizures; are pregnant, think you might be pregnant, or are trying to become pregnant; are breastfeeding or plan to breastfeed. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Serotonin syndrome is a rare but serious problem that can happen in people using TREXIMET®, especially if used with antidepressants called SSRIs or SNRIs.
The most common side effects of TREXIMET® include: dizziness; feeling weak, drowsy, or tired; pain, discomfort, or stiffness in your neck, throat, jaw, or chest; nausea; tingling or numbness in your fingers or toes; heartburn; dry mouth; feeling hot; heartbeat problems; and muscle tightness.
For more information, please see the complete Prescribing Information, including BOXED WARNINGS, and the Medication Guide.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Treximet is a registered trademark of Pernix Ireland Limited.
[i] NINDS Migraine Information page. National Institute of Neurological Disorders and Stroke. Retrieved July 6, 2017 from https://www.ninds.nih.gov/Disorders/All-Disorders/Migraine-Information-Page
[iii] Migraine Research Foundation. Migraine Facts. Retrieved July 12, 2017 from http://migraineresearchfoundation.org/about-migraine/migraine-facts/
[iv] Migraine.com. Difficulty concentrating. Migraine.com. Retrieved July 12, 2017 from https://migraine.com/migraine-symptoms/difficulty-concentrating/.
[v] NINDS Migraine Information page. National Institute of Neurological Disorders and Stroke. Retrieved July 6, 2017 from https://www.ninds.nih.gov/Disorders/All-Disorders/Migraine-Information-Page
[vi] Ripa P et al. Migraine in menopausal women: a systematic review. International Journal of Women’s Health. 2015;7:773-782. https://doi.org/10.2147/IJWH.S70073
[vii] Wöber-Bingöl, Ç. Epidemiology of Migraine and Headache in Children and Adolescents. Current Pain and Headache Reports. 2013;17:34.1. doi:10.1007/s11916-013-0341-z
[viii] NINDS Migraine Information page. National Institute of Neurological Disorders and Stroke. Retrieved July 6, 2017 from https://www.ninds.nih.gov/Disorders/All-Disorders/Migraine-Information-Page
[x] Migraine Buddy. Migraine Symptoms: The Stages of a Migraine. Retrieved July 6, 2017 from http://www.migrainebuddy.com/migrainesymptoms-the-stages-of-a-migraine/
[xi] Migraine Research Foundation. About Migraine. Retrieved July 6, 2017 from http://migraineresearchfoundation.org/about-migraine/
[xii] The Migraine Trust. Menopause and Midlife. Retrieved July 6, 2017 from https://www.migrainetrust.org/about-migraine/trigger-factors/menopause-and-midlife/
[xiii] Office on Women’s Health, U.S. Department of Health and Human Services. Migraine Fact Sheet. WomansHealth.gov. Retrieved July 6, 2017. https://www.womenshealth.gov/publications/our-publications/fact-sheet/migraine.html#j
[xiv] Rains J. Sleep Disorders and Headache. American Migraine Foundation. December 16, 2016. Retrieved July 6, 2017. https://americanmigrainefoundation.org/understanding-migraine/sleep/
[xv] The Migraine Trust. Hypoglycaemia. Retrieved July 11 from https://www.migrainetrust.org/about-migraine/trigger-factors/hypoglycaemia/
[xvi] American Migraine Foundation. Effects of Exercise on Headaches and Migraines. American Migraine Foundation. November 1, 2015. Retrieved July 6, 2017. https://americanmigrainefoundation.org/understanding-migraine/effects-of-exercise-on-headaches-and-migraines/
[xvii] Katsarava Z et al. Defining the Difference Between Episodic Migraines and Chronic Migraines. Current Pain and Headache Report. 2012;16:86-92. DOI 10.1007/s11916-011-0233-z
[xviii] Pernix Therapeutics. TREXIMET Prescribing Information. May 2016.