The Woman's Migraine Toolkit: Managing Your Headaches from Puberty to Menopause

241 Pages·2010·3.529 MB·English

by  Dawn A. Marcus M.D., Philip Bain

Practical Guidelines for Managing Women’s Migraines
“ . . . inside this book are the tools you can use to control and take ownership
of your headaches.”
—Michael Ready, MD, Director, Headache Clinic, Scott and White
Th
Memorial Hospital, Temple, Texas

e
“ . . . one of the best books about migraine . . . packed with valuable information
W
that’s presented in a way that’s easy to read and easy to refer to again . . .
Woman’s
—Teri Robert, Author of Living Well with Migraine Disease o Th e

and Headaches m
M a
igraines aff ect one in every six women, more than 20 million in
n
Migraine Toolkit
the U.S. alone. Th e Woman’s Migraine Toolkit provides practical ’s
management guidelines for headaches in girls and women, empha- M
sizing the relationship to the hormonal changes that accompany puberty, the
menstrual cycle, and menopause. Its practical focus is directed to minimizing i
g
or eliminating the symptoms of migraine and its associated loss of time from r
a
work and leisure activities.
i managing your headaches
Th e Toolkit will help readers take charge of their migraines by learning what n
e
causes them and eff ective treatments for every stage in a woman’s life. Use- from puberty to menopause

T
ful tools, quizzes, and diaries for evaluating headaches and determining the
o
best treatment are provided through the book, and downloadable versions are
o
available on the publisher’s and authors’ websites. Practical instructions are
l Dawn A. Marcus, MD
provided for eff ective non-drug and medication therapies, as well as advice k
about how natural remedies and nutritional supplements that can help at each i
t
and Philip A. Bain, MD
stage of life.

Dr. Dawn A. Marcus is a board-certifi ed neurologist and professor at the M
University of Pittsburgh Medical Center, where she specializes in headache a ▶ Why women have more migraines:
r
and pain management. Her interests include treating migraines in women, c hormones, hormones, and more hormones
u
menstrual migraine, and migraine during pregnancy. s
▶ Migraine management at all stages of life: what really works!
&
Dr. Philip A. Bain is a practicing internist in a large multispecialty organi- B ▶ Learn about:
zation in Madison, WI. His patients enjoy the practical educational tools and a
i ■ migraines during childhood and adolescence
n
handouts he has developed and uses routinely in his practice.
■ controlling menstrual migraine
■ safer treatment of migraines with pregnancy and nursing
■ managing migraines during menopause
IISSBBNN: 997788--0--99882233212-192-9-82 - 8 $14.95 ▶ Includes medications, non-drug treatment options,
150 east 61st street 5 1 4 9 5
and nutritional products and supplements
new york, ny 10065
www.diamedicapub.com Cover design by Gopa & Ted2, Inc 9 780982 321928
MMiiggrraaiinnee CCoovveerr__MMeecchhaanniiccaall__FFiinnaall..iinndddd 11 1100//1155//1100 66::1199::4411 PPMM
Migraine 00:Layout 1 10/17/10 4:08 PM Page i
Praise for The Woman’s Migraine Toolkit
“...(Thebook)iswelllaidoutandorganizedintosectionsthatmakeit
easy to read, whether you’re reading it straight through or looking for
specific information. The illustrations add to the information without
distractingfromit.Awiderangeofpossibletreatmentsarediscussed...
The information about medications is supplemented with helpful
charts for comparison and quick reference . . . packed with valuable
information that’s presented in a way that’s easy to refer to again later.
With bulleted lists, charts, and relevant illustrations, this is one of the
best presentations of large amounts of information you can find in
print.”
—TeriRobert,PatientAdvocateandAuthor,
LivingWellwithMigraineDiseaseandHeadache
“...abedrockfoundationofessentialpracticalinformationthatcanbe
builtupon...Ispendagreatdealof timeeducatingmypatientsabout
their condition and what it will take to control the chaos that has
become their migraines. At the end of the day there is never enough
timeinthedaytodoitallbyyourself.TheWoman’sMigraineToolkitis
aperfectpartnertopickupwheremyappointmentsleaveoff...”
—MichaelReady,MD,Director,HeadacheClinic,
ScottandWhiteMemorialHospital,Temple,Texas
“...acomprehensiveyetclearandreadablereviewofmigrainethattar-
gets issues of particular importance to women...It contains practical
advice and action steps that you can take on your own,advice on how
to talk with your health care provider about your migraine,and ques-
tionnaires and logs that you can complete and share with your health
careprovider.”
—DawnBuse,M.D.DepartmentofNeurology,
AlbertEinsteinCollegeofMedicine,Bronx,NewYork,
andDirectorofBehavioralMedicine,MontefioreHeadacheCenter
Migraine 00:Layout 1 10/17/10 4:08 PM Page ii
“...ausefultoolkitforthewomanwhowishesnotonlytounderstand
her migraines,but to be an active participant in her treatment.Clearly
organizedintosectionsthatspeakdirectlytoitsaudience...eachgen-
erouslyendowedwithchartsandillustrations...chockfullofcalendars,
diets, exercises, and websites. It answers common questions, addresses
pharmacologic and non-pharmacologic approaches to treatment, and
even offers advice on how to be more effective in communicating with
yourphysician.”
AnneH.Calhoun,M.D.,CarolinaHeadacheInstitute,
ChapelHill
“ . . . highly recommended for its clarity, to-the-point simplicity, yet
depth of information.(The book) begins with a complete explanation
of thebiologyandcausesof migraineittermsthatapatientcanrelate
to. It clearly summarizes what happens to women as they go through
their hormonal changes from young girls to postmenopausal adults,
accurately depicts the many phases and problems of migraine,and an
exhaustivebodyof informationonalltypesof therapy...Itreallyisa
toolkit,explaining best treatments of all aspects of your headache and
allpointsinyourlife.Itcloseswithhelpfulhintsontalkingtoyourdoc-
tor and an excellent and complete resource guide.I will recommend it
oftentomypatients.”
—AlanM.Rapoport,M.D.,ClinicalProfessorofNeurology,UCLA;
FounderandDirector-Emeritus,
TheNewEnglandCenterforHeadache
“...holdsawealthof informationforunderstandingaswellasmanag-
ing migraine. As the title indicates, the book is directed toward the
woman headache sufferer, with chapters on treating migraine during
menses,pregnancy,andmenopause.Thechapteronhormoneswasmy
personalfavorite;Ifounditcomprehensiveyetcogent...Itriedtoread
the book from a patient’s rather than a physician’s perspective, and
foundtheexplanationstobelogicalandwell-structured,andthewrit-
ing style fluid.The shaded boxes highlighting treatment tips as well as
Migraine 00:Layout 1 10/17/10 4:08 PM Page iii
important information and summaries, add to the readability . . . an
outstanding resource for the well-educated reader, including health
professionalswhotreatmigraine.”
—GretchenTietjen,MD,ProfessorandChairofNeurology,
DirectoroftheUTMCHeadacheTreatment
andResearchCenter,UniversityofToledo
“ ...a must read for all women with migraines.This book explains in
an easy to read and easy to understand format what causes migraines,
why women are more likely to get migraines, and how hormonal
changes influence migraines. More importantly, this book empowers
women with the knowledge of what they can do to manage their
migraines.Howtouserelaxationtechniques,biofeedback,andstretch-
ingexercisesareexplainedwitheasystep-by-stepinstructionsandillus-
trations...Includedisathoroughdiscussionof whichmedicationsare
safe during pregnancy, breastfeeding, and menopause. This is a well-
written, comprehensive guide that I will highly recommend to all my
migraine patients.As a gynecologist who treats many female migraine
patients,thisisthebookIhavebeenwaitingfor.TheWoman’sMigraine
Toolkit will enable women to take control of their migraine manage-
ment and work with their physicians to set up a treatment plan that
worksforthem.KnowledgeisPower.”
—DebraL.Hill-BusselleM.D.,FACOG,GynecologistandWomen’s
HealthcareSpecialist,Bozeman,MT
“If any of you are migraine sufferers or live with someone who gets
them, please get this book. It is very hard for people who do not get
migrainestounderstandhowdebilitatingtheycanbeforthosewhodo
and this book does a wonderful job of explaining what it is we experi-
ence. . . Please, please, please, if you love someone who has migraines
(includingyourself)getthisbooksoyoucanhelpthemhelpthemselves
tohandleandevenperhapspreventthesedebilitatingheadaches.Lifeis
tooshorttospenditinpainwhenitisn’tnecessary.
—The1000BookList
Migraine 00:Layout 1 10/17/10 4:08 PM Page iv
“. . . very informative . . . a good, helpful book for women who suffer
frommigraines.”
—AmazonEarlyReviewer
“OnthewholeIlikedthisbook. It’saccessible,friendly,andreassuring.
Alotoftheadviceitoffersisimmediatelyuseful,bothintermsofunder-
standingthemigraineexperienceandmanagingit.Itincludesthingslike
stretchesandexercises,suggestionsforcommunicatingwithhealth-care
providers,discussions of various medications and alternative medicine
approaches,andthegeneticsof migrainesusceptibility...
—AmazonEarlierReviewer
“ ...great information on relaxation stretches,drug and herbal treat-
ments, diet triggers—all sorts of things to help someone cope with
migraines. Itdiscussescurrentmedicalmodelsof migraines...Italso
has a wonderful section I wish I had read years ago on preparing for a
medicalappointment. Ithinktheinformationtherewouldbeincredi-
blyusefulandempoweringinthatsetting...Ihighlyrecommendthis
book,especiallyforsomeonenewlydiagnosed...”
—AmazonEarlyReviewer
Thesubtitleofthisbookis“ManagingYourHeadachesfromPubertyto
Menopause,”and that pretty much covers the book. I consider myself
pretty knowledgeable about migraines.I’ve suffered from them since I
was13,andwitnessedmymothercopingwiththemtothepointofhos-
pitalization. From the very beginning of this book, though, I learned
new things—such as that I’ve been medicating myself at the wrong
stage of the cycle,which is why drugs often do very little to help with
thepain...Iappreciatedthebook’sapproach,whichiseasytounder-
standforlaymenbutnotdumbeddown,either.Chaptersoutlinepossi-
ble treatments, ranging from massage techniques to prescriptions to
naturalremedies...ThisisoneI’llbekeepingonmyshelf—thatis,after
Iletmymomborrowit.
—LibraryThingReviewer
Migraine 00:Layout 1 10/17/10 4:08 PM Page v
The Woman’s Migraine Toolkit
Managing Your Headaches from
Puberty to Menopause
DawnA.Marcus,MD
Professor,DepartmentofAnesthesiology
Universityof Pittsburgh
Pittsburgh,Pennsylvania
PhilipA.Bain,MD
Departmentof InternalMedicine
DeanHealthSystem
Madison,Wisconsin
Migraine 00:Layout 1 10/17/10 4:14 PM Page vi
DiaMedicaPublishing,150East61stStreet,NewYork,NY10065
Visitourwebsiteatwww.diamedicapub.com
Copyright©2011byDawnA.Marcus,MDandPhilipA.Bain,MD.AllRightsReserved.
Nopartofthisbookmaybereproducedinanyformorbyanymeans,whatsoever,elec-
tronicormechanical,includingphotocopying,recording,orbyanyinformationand
retrievalsystem,withoutpermissioninwritingfromthepublisher,exceptforbriefquo-
tationsembodiedinarticlesorreviews.
LibraryofCongressCataloging-in-PublicationDataisavailablefromthepublisher.
DiaMedica titles are available for bulk purchase,special promotions,and premiums.
For more information please contact the publisher through the publisher’s website:
www.diamedicapub.com.
Disclaimer:
The content in this book is not intended as a substitute for medical or professional
counselingandadvice.Thereaderisencouragedtoconsulthisorherphysiciansand
therapists on all health matters, especially symptoms that may require professional
diagnosisand/ormedicalattention.
ISBN:978-0-9823219-2-8
BookandcoverdesignbyGopa&Ted2
IllustrationsbyIanS.Klipa
DesignbyTypeWriting
EditingbyJessicaBryan,JoannWoy
Migraine 00:Layout 1 10/17/10 4:08 PM Page vii
Contents
Preface xi
Acknowledgments xv
1 An Overview of Migraine
WhatAre Migraines?Why Me? 1
UnderstandingtheBiologyof Migraine 1
MigrainesAreOftenInherited 13
GettingaDiagnosis 20
Summary 27
2 Headaches from Puberty to Menopause
Hormones,Hormones,and More Hormones 29
HormonesPlayaKeyRoleinHeadacheDevelopment,
EspeciallyinWomen 30
DoKidsHaveSexHormones? 33
HowDoHormoneLevelsChangeovera
Woman’sLifetime? 38
WhattoExpectDuringChildhoodandAdolescence 39
WhattoExpectwithMensesandOralContraceptiveUse 40
WhattoExpectwithPregnancyandDelivery 42
WhattoExpectwithMenopause 46
Summary 48
vii
Migraine 00:Layout 1 10/17/10 4:08 PM Page viii
viii | CONTENTS
3 Migraine Management
What ReallyWorks? 51
LearningAboutYourHeadacheThreshold 52
Non-DrugTreatmentOptions 54
MedicationTreatmentOptions 81
NutritionalProductsandSupplements 91
PuttingTogetheraTreatmentPlan 96
PracticeLogsforNon-DrugTreatments 103
Summary 106
4 Controlling Migraine During
Childhood and Adolescence
107
HeadacheManagementDuringSchool 109
MedicationsforMigraine 119
Non-DrugTreatmentsforMigraine 122
NutritionalSupplementsforMigraine 126
Summary 128
5 Controlling Menstrual Migraine
129
WhatIsMenstrualMigraine? 130
Non-DrugOptionsforMenstrualMigraine 133
MedicationOptionsforMenstrualMigraine 134
NutritionalSupplementsforMenstrualMigraine 140
Summary 141
6 Safe Treatment of Migraines During
Pregnancy and Nursing
143
Pre-PregnancyPlanning 144
Pregnancy 149
Non-DrugTherapies 152
HeadacheMedications 159
Migraine 00:Layout 1 10/17/10 4:08 PM Page ix
CONTENTS | ix
PreventionDrugs 164
RescueTherapy 166
NaturalRememdiesforMigraineandNausea 168
AfterPregnancy 170
Summary 179
7 Tackling Migraines During Menopause
181
KeyQuestionsforYourDoctor 182
Non-DrugTreatments 186
HeadacheMedications 187
NaturalProducts 189
Summary 190
8 Learning How to Talk to Your
Healthcare Provider
193
FocusontheMostImportantQuestions 198
MakeCertainYouUnderstandYourDiagnosis 199
ShareYourConcernsandReactions 200
UnderstandYourTreatmentRecommendations 200
WhattoDoBeforeYourVisit 201
WhattoTalkAboutatYourFirstHeadacheVisit 202
QuestionsYouShouldAskatEveryVisit 203
Summary 204
9 Resource Guide
Where Can I Get More Information? 207
FindingReliableInternetResources 208
ReadaGoodBook 211
Index 217