Dr Ciara Kelly: Top tips for battling through migraines

Women who suffer with classical migraine should avoid going on The Pill.

Don't take the Pill if you have migraines

Dr Ciara Kelly

All of us get headaches from time to time, particularly when we're stressed or unwell but migraine is a different kettle of fish.

Migraines are episodic attacks of headaches, often associated with nausea, vomiting and visual symptoms, which completely resolve between attacks.

It's very common - one in four women and one in twelve men will experience it during their lifetime - and for some it can be debilitating, resulting in spending three days in a darkened room, in severe pain, throwing up.

Migraines have a few notable features, that differentiate them from other headaches. They usually occur on one side of the head only - normally at the front or to the side, although it can spread from there to all over the head.

They're often described as throbbing or pulsatile in nature. And it hurts to move your head when you have one. They're vary from moderate to severe in terms of pain and can last from about four to seventy two hours.

Contrast that with tension headaches for example which are usually a tight band of pressure across the front of your head, aren't pulsatile and have no associated features.

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Classical migraine, is preceded by an aura - which is often described as flashing lights, at the edge of the peripheral vision. People say it's like something shimmering at the corner of their eye. Some people even partially lose their sight temporarily.

But there are other types of aura too. Some people gets pins and needles, numbness, tingling or weakness - or indeed weird and esoteric auras such as odd smells or sensations. But by far the visual aura is the commonest.

Migraines often run in families and children can get them too although they often present a little differently -sometimes even as abdominal pain.

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It is of course very important to note that if you do get weakness, loss of vision or other unusual symptoms with a headache and you don't have a diagnosis of migraine, you should seek medical attention immediately as it may be a sign of a stroke or other serious neurological condition.

Triggers that spark the headache are another feature of migraines. So eating certain foods - such as cheese, chocolate or foods containing the additive tyramine. Looking at computer screens. Cigarette smoke or stress, can all bring them on.

For some people menstruation or sex can be a trigger. Drugs such as the oral contraceptive pill, HRT or sleeping tablets can also cause them.

So what do you do if you are getting migraines?

Well first things first - painkillers! Take them early in an attack to prevent the migraine from becoming full blown.

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A combination of Paracetamol and anti-inflammatory medications such as ibuprofen works well. Simple aspirin has also been shown to be effective - with dissolvable medications being the fastest acting.

You may also need an anti-sickness tablet such as domperidone, if nausea is a key feature. Triptan medications - available only on prescription, may be required if painkillers fail to contain it. Or if your migraines are very frequent, your doctor may instead prescribe a daily medication, to try and prevent them occurring.

You should also keep a headache diary, to see if you can identify yourself what's bringing on your migraine. On any day you get an attack, write down everything you've eaten that day, what you're doing and how you're feeling. That way you may be able to avoid your personal triggers.

Another important note, is that woman who suffer from migraine with aura, should not take the combined oral contraceptive pill because of a small but significant increased risk of stroke.

In my experience many women are unaware of this and are taking The Pill, despite being classic migraine sufferers.

Avoiding triggers, acting fast with painkillers or using triptans, is the best way to manage migraine. That and living a stress-free life. Hmmm, can someone please pass the paracetamol?

@ciarakellydoc