Letters published in response to a recent article on migraines highlight the condition's misunderstood nature. Sarah Khan from London writes that framing migraines around headaches understates their systemic impact, describing them as a neurological event where head pain is only one component.
Personal experiences with migraine
Khan notes that until perimenopause, her head pain was minor, but disabling symptoms like fatigue, body aches, and cognitive fog dominated. This led to decades of misdiagnosis, with her condition blamed on a weak immune system rather than a neurological disorder.
She also criticizes the advice to manage triggers, pointing out that hormonal changes during puberty, reproductive years, and perimenopause are beyond control. For some, menstrual attacks and ovulation can consume half the month, while perimenopause can trigger daily attacks.
Need for broader medical care
Khan argues migraine cannot be left to neurologists alone, as hormonal drivers require gynaecological expertise, yet few gynaecologists understand the migraine brain. She notes that gepants like Rimegepant are transformative but access remains uneven.
Rab Hallett from Edinburgh emphasizes talking to a GP, sharing that after years, a pain management consultant prescribed triptans, which improved his life. He advises against suffering in silence or self-managing by avoiding triggers.
