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They affect one in five women and are the second cause of incapacity for work, but the research on these acute headaches remains small and the funds they receive are scarce. For what is this?
The first time I suffered a migraine was an afternoon after leaving school.
A small discomfort in the head ended up becoming an excruciating pain that clouded my vision and turned the light in the room into a source of pure agony.
Then the vomit came.
It is a cycle that I have lived innumerable times in recent years. One of those times, the migraine forced me to give up my work and keep the feeling that nothing could help me anymore.
But while a simple headache can happen with an aspirin or an ibuprofen, migraine is aggressive and can end up weakening the sufferer.
And it has not yet been discovered what is the exact reason why it occurs (hormones and abnormal brain activity are only two possible theories) and there is no sustainable treatment offered by doctors.
Therefore, it is perhaps not surprising that in the most important global survey of well-being made by the World Health Organization, with data from 195 countries, it reveals that, every year from 1990 to 2016, migraine attacks were the second leading cause behind the years of life with disabilities.
This is the second most frequent condition on the list of those that make a person feel unable to work or perform their normal daily activities.
And although it is one of the main causes of incapacity for work – only in the United Kingdom, for example, it has a cost of US $ 29 million for health services and businesses – it remains one of the least studied diseases in the world. planet.
Not only that: it is a condition suffered mostly by women. One in five, to be precise, while the prevalence in men is one case per 15.
Why them? Again, the reasons are unclear.
An investigation by the University of Arizona , published in April 2018 and conducted with male and female rats, showed that perhaps one of the reasons is the relationship between high levels of estrogen and low levels of the enzyme NHE1.
Without enough NHE1 in the body, pain signals increase exponentially.
“Based on these findings, we think that women are more susceptible to suffering from migraine attacks because the magnitude of their hormonal fluctuations causes the level of NHE1 to change,” explained researcher Emily Galloway.
However, paradoxically, most of the research that has been done on migraine uses male specimens in the laboratory, even though in real life it is women who suffer the most.
These severe headaches are one of the oldest ailments recorded by mankind.
Writings found in Egypt and dating from 1,200 BC accurately describe this evil.
However, the first more accurate description, with symptoms and name, is due to a Greek doctor of the second century, Areteo of Cappadocia.
In fact, the word migraine comes from the Greek word ” hemicrania “, which means “half skull”.
But despite the medical classification, the treatment to alleviate it was always conditioned by superstition.
In the Middle Ages remedies related to witchcraft were suggested, such as the application of a clove of garlic on the temples.
Others recommended trepanation: a practice that consists in piercing the skull. This aggressive procedure was used to free evil spirits from those suffering from mental illness, according to the beliefs of the time.
But beyond these questionable treatments, it was not until the nineteenth century that doctors began to notice the higher prevalence of migraine in women.
Although, again, the diagnoses were unsuccessful. Many of the specialists at the time pointed out that it was a mental illness that they called “disorder of low-class mothers”, whose minds were said weakened by daily work, lack of sleep, breastfeeding and malnutrition.
Women suffering from these acute headaches were ridiculed and labeled hysterical, which gave rise to the stigma of neurosis that has not yet been completely eradicated.
“It was a disease that was related to a delicate nervous system, and it was considered that women did not have the same capacity as men for intellectual work and, as a consequence, they were more susceptible to over-demanding their ‘weak nervous system’,” he explained. Joanna Kempner, professor of sociology at Rutgers University.
In fact, the one who is considered the modern father of the research on headaches, the American Harold G. Wolff, established a similar difference between the migraine of men and that suffered by women.
According to him, men were ambitious and successful and only suffered from migraine when they were tired.
While women suffered from these severe headaches because they were unable to accept their role as women, particularly when it was related to sex.
According to Wolff, women ” believe that sex is, at most, a reasonable marital duty, and in many cases, for them it is frankly unpleasant and they resent it.”
“By the end of the 20th century, migraine was almost synonymous with neurotic housewives, and in some dictionaries the word migraine was listed as synonymous with wife,” Kempner said.
It can not be denied that there seems to be a relationship between this ailment and mental health.
Many investigations conclude that migraines are associated with different psychiatric disorders.
A 2016 study noted that people who suffer from it are almost three times more likely to develop generalized anxiety disorder (GAD), while patients with depression are three times more likely to suffer from migraine attacks.
Another study found that one in six people with recurrent migraines have had suicidal thoughts at some point in their lives (the average in the general population is one in 10).
” But the big question is whether there is a causal relationship: when you have a disorder like migraine, the likelihood of it overlapping with other diseases is very high,” said Messoud Ashina, director of the Migraine Research Unit Denmark.
And of course, suffering from migraines can also lead to poor mental health, instead of being the “delicate mental constitution” that leads to migraines as Victorian doctors believed.
But, beyond the debilitating effect, the condition is surprisingly little understood or investigated.
” Many neurology specialists consider migraine to be a benign disease , it’s not cancer, it’s not Parkinson’s, but if you look at the personal and public impact it has, it’s a big problem,” Ashina said.
The professor of neurology at the Mayo Clinic in Arizona, USA, Arleen Starlingpoints out that, in the medical community, many do not consider migraine as a topic of study for “serious” neurology.
And part of that difficulty may be based on a gender bias: it is already known that, in general, women have greater difficulty in taking their symptoms seriously or in order to arrive at an accurate diagnosis, in comparison with men.
According to experts, the large number of patients suffering from migraines should mean that the specialists know the condition well.
But it’s not always like this:
“Headache is the most common symptom among neurology outpatients and it is the one that is least taught to specialty physicians, it’s like training electricians but not telling them about light bulbs,” one source told Kempner . When he wrote his book “Tonight no: migraine and gender and health policies”.
Fortunately, a new treatment seems to be on the way: an injection called Erenumab , which is administered once a month and blocks a receptor in the brain that triggers the migraine attack.
” The interesting thing about this new drug is that it was designed specifically to combat migraine , not created for another disease and that it turned out could help relieve migraine,” Starling said.
“And being a drug created for a specific disease, the toxicity is lower, that is, it has fewer side effects,” he added.
As a patient affected by migraines, I can not be more excited. Currently the treatment I follow is with beta blockers, which were originally designed for hypertension.
It turned out that they also fought the migraine, but they are not a specific drug for this condition, so I suffer constantly from fatigue, dizziness and, if I stop taking it suddenly, I can have a heart attack.
Now, after spending six months without migraines, I am in the process of reducing the dose.
My goal? Get to the point of ” zero medication “.
But recently I had a new attack, and a few months before I had to be hospitalized because I had all the symptoms of a heart attack.
Luckily it was a false alarm. But it opened my eyes about the need for a treatment for my migraine that does not affect my vital organs.
Luckily, it seems that a solution is already on the horizon.