Chronic migraine headaches happen at least 15 days each month, resulting in missed work, school, and lost time you can never fully get back. These blinding headaches affect women far more often than they do men. There is no cure for migraine, but many treatments are available to help prevent these headaches or shut them down once they start. No one-size-fits-all treatment plan exists. Sometimes you have to try many things to find what makes the difference for you. Here, three women share their stories about triumphing over chronic migraine.
Back in the Game: Jessica’s Chronic Migraine Story
Jessica Michelle, now 34, remembers the first time a migraine headache hit her like it was yesterday — even though it was about 20 years ago. “My symptoms were a debilitating headache that would not go away and feeling extremely lightheaded,” she recalled.
That was her first, but unfortunately not her last migraine.
“It feels like there is a drill in my head, making it hard to concentrate or do anything without being in debilitating pain,” said the New York City-based legal assistant. Because of headaches, she has also had to cancel dates and hard-to-get reservations at trendy eateries.
She’s seen every type of headache specialist over the years, including neurologists, psychiatrists, alternative medicine practitioners, and more — all as part of her quest to find lasting relief.
The list of treatments she has tried includes erenumab (Aimovig), galcanezumab (Emgality), rimegepant (Nurtec), and ubrogepant (Ubrelvy). These drugs block a protein called calcitonin gene-related peptide (CGRP), which plays a role in migraine pain. Some are for prevention, and others can stop a migraine that has already started.
Michelle has also tried triptans, such as eletriptan (Relpax) and zolmitriptan (Zomig). These migraine drugs work by activating the brain chemical serotonin, which helps shrink blood vessels and block pain pathways during a migraine attack. Triptans don’t prevent migraine attacks, but they may help ease pain when one has already started.
Michelle also tried propranolol, a blood pressure drug that is also used to ward off migraines, and she wasn’t happy with the results.
This trial-and-error period went on for years.
“The combination of Botox injections and Emgality works the best for me,” she said. “I would say it reduces my migraines by 50%. I still take the over-the-counter painkiller ibuprofen (Advil, Motrin) as needed.”
When injected into muscles in the head and neck, botulinum toxin, aka Botox (the same shot used to smooth wrinkles), can prevent migraine attacks.
“Before I started my current treatment, I would often get migraines more frequently,” she said. “If I don’t take medication for them, it’s hard to function.” She has also learned to avoid her triggers, namely, too much caffeine, not enough sleep, processed foods, sugar, and alcohol.
It’s been a learning curve, she says. “It took me a while to figure out what makes my migraines occur and how to stop them, but I am grateful for every headache-free day I’ve had since.”
One of the Lucky Ones: Ann’s Chronic Migraine Journey
Ann Babbitt, now 50, hasn’t had a migraine headache in 10 years, and she is beyond grateful. She was 7 or 8 years old when she got her first migraine. “I had a throbbing in one or both temples and an ache in my neck that almost felt like I could not hold my head up,” she said.
The Atlanta native recalls multiple monthly migraines from the age of 10 to 30. “They were mainly triggered by a change in the weather or a drastic change in my stress level,” she said.
Many women report that their migraine attacks coincide with menstrual cycles. “I did not get them around my period, but years later I realized it likely had something to do with when I was ovulating,” said Babbitt, who now works in media relations in New York City.
She tried biofeedback to learn how to control her body’s responses and lower stress and pain. She tried blood pressure-lowering medications called beta-blockers to try to stop a migraine from coming on. And she tried the anti-seizure drug topiramate (Topamax) and magnesium supplements to minimize her migraine attacks. Magnesium may help prevent the aura or vision trouble that comes on before a migraine and may also soothe pain.
“When I was young and there were not the kinds of drugs they have now, I was always given [the over-the-counter painkiller] Excedrin taken with a Coca-Cola,” she recalled.
“Once triptans came on the market, I absolutely relied on those for pain management,” she said. “I have taken them all at one time or another.”
Babbitt was lucky. Her migraine attacks went away about 15 years ago. “I was trying to get pregnant, and I came off birth control pills. I was petrified because I was sure I was going to have horrible headaches, and the headaches have really diminished.”
Some people do outgrow chronic migraine headaches. “I have not filled a prescription for triptans in years,” Babbitt says.
When she does get an occasional headache, she reaches for the Coca-Cola and Excedrin. “It does the trick at this point, which is kind of miraculous.”
“A Little of this and a Little of that:” Michele’s Migraine Treatment Journey
Michele Rapnikas, now 58, was sidelined by her first migraine headache when she was 21. This is slightly older than most folks are when they start experiencing migraine attacks, as these headaches typically start in childhood or during the teen years.
But Rapnikas’ migraine attacks came on after she sustained a traumatic brain injury (TBI) following a car accident during her time as a U.S. Marine in 1989. Unfortunately, this is common. TBIs can cause migraine, often called post-traumatic migraine.
Her migraine attacks started with what she calls tunnel vision.
“I couldn’t see anything in my peripheral vision, and the headache came on after that,” said the resident of Edisto Island, South Carolina. “If you were looking at [a] computer, it feels like a pixel is off and then that grows and grows,” she explained. When it goes away, the pain comes, and so does the nausea.
These vision changes are her aura. “I can sometimes tell days before a migraine is coming because I may start losing my words or have uncontrollable yawning.”
Once the headaches started, she was down for the count. “I would lay in my closet in the fetal position with no light or sound for what could be three days,” she recalled. Her child would tiptoe into her room and whisper ‘hi mommy’ during these episodes.
She, like most women with chronic migraine headaches, has tried many things over the years to stop the pain, with varying degrees of success.
The anti-seizure medication topiramate (Topamax) can prevent migraine headaches, and it worked really well for Rapnikas. That is, until it started causing side effects, including kidney stones that ultimately led her to have a kidney removed.
The triptans weren’t that helpful for her, as their side effects, such as weight gain and dizziness, seemed to outweigh any benefits. She also underwent Botox injections into her head and neck every six weeks and nerve block injections to numb the area and ease her pain.
She has found that what works best for her is a monthly shot of galcanezumab-gnlm (Emgality) for migraine prevention.
She was doing well with this shot for a while, but she recently changed health care systems. She’s now starting from scratch again due to changes in the list of prescription drugs her new health insurance plan covers.
Avoiding triggers can be tricky. “If light glints into my eyes through the trees or blinds, I can get a migraine.” Other migraine triggers include caffeine the scent of lilies.
“If I drink a cup of regular coffee once in a great while, that’s OK, but two cups of coffee two days in a row is definitely not.”
She also undergoes acupuncture and uses an at-home device that sends pulses to her brain to help lower stress and pain every other day for 45 minutes, both of which are helpful.
“A little of this and a little of that makes it so I don’t have to spend days on the closet floor anymore,” she said.
Before You Try
Get a proper chronic migraine diagnosis from a headache specialist before trying to treat yourself, said Brian M. Grosberg, MD, Director of the Hartford HealthCare Headache Center in Hartford, Connecticut.
Be patient. “This may be a marathon, not a sprint, but you and your headache specialist will find something that works for you and your chronic migraines.”
Keep a detailed monthly headache diary. “Write down the frequency and intensity of your headaches along with their timing, your sleep pattern, mood, and where you are in your menstrual cycle," says Grosberg. Share this information with your doctor to help find the best treatment for you. “It may be a combination of treatments, but it is out there.”
