Migraines: the gender bias behind one of the world’s most debilitating conditions

At seven years old, feeling your eyesight disappear into TV static is terrifying. At the age of 20, with the weight of thirteen years of knowledge of what comes next, it is somehow even worse. It starts very subtly, suddenly I notice I can’t see my friend’s nose even though the rest of their face is clear as day, then I realise if I shift my head their eye disappears. The blind spot quickly takes over half my vision and I’m left stranded wherever I am completely incapacitated– I cannot see, I cannot walk without support, I cannot think because the fear and the splitting headache soon overtakes me. I am left completely reliant on friends (if I’m lucky) or strangers (if I’m not) to get me home – all in the blink of an eye.

The loss of my vision is at once terrifying in its own right and yet only the precursor to what’s to come. Migraines are not just a ‘bad headache’. Imagine the most painful headache you can – unless you’ve had a migraine yourself, you’ll have maybe gotten a fraction of the way there.

The panic quickly sets in because I know I am going to be consumed by pain, but I don’t know for how long. It can last anywhere from a couple of hours to being the start of a week-long set of episodes. This is why I was not surprised when I heard that migraine sufferers are 2.5 times more likely to have Generalised Anxiety Disorder than the general population. People with depression are three times more likely to also be victims of migraines.

Migraines are incredibly common. It is estimated that 1 in 7 people suffer from them to some extent, making it the third most prevalent illness in the world. So why then is this condition that is so common and so painful not talked about more? Why is research into it the most underfunded of all neurological illnesses relative to its economic impact? Migraines are one of the most frequent causes of employee absences and they are estimated to cost the NHS £150 million a year. Since it is so prevalent, painful and costly it seems strange that there is no serious effort into finding a cure.

The answer to why it is not taken seriously lies in who the main sufferers are – women. Women are disproportionately more likely to suffer from migraines than men – 1 in 5 women experience them, compared to 1 in 15 men. Migraines are not taken seriously because women suffer gender discrimination in healthcare just like everywhere else in society. Women who go to A&E wait longer to see a doctor, are less likely to have their pain taken seriously and are less likely to be given the strongest and most effective pain killers. This is because there is a gender pain bias – people of all genders are more likely to write off the pain of women as exaggerated or ‘psychosomatic’ (e.g. all in their heads). Women are often written off as having psychological problems and prescribed anti-anxiety medication when they go to doctors with pain then men are.

One of the main reasons for this is the long association of women’s pain with ‘hysteria’. In the 1800s the standard response to migraines was to label them as a neurotic housewife’s illness and prescribe more housework to keep them busy. Although men do suffer from migraines as well, the general image of them remains a predominantly female illness. This legacy of trivialising women’s migraines as exaggeration and hysteria often precludes serious treatment even now.

Modern medical research falls pitifully short of taking women-dominated conditions like migraines seriously. Shockingly, headaches and headache-related conditions are not on the curriculum in 75% of English undergraduate medical degrees despite migraines being ranked as the seventh most disabling illness globally by the World Health Organisation.

The bias against women’s pain in medicine has debilitating impacts for women. Women are more likely to be misdiagnosed with psychological rather than physical illnesses and this can lead to preventable deaths. Just because migraines are not a fatal condition doesn’t mean they shouldn’t be taken seriously, because the impact on people’s lives and mental health when suffering from them is as serious as more recognised illnesses.

by Daisy Thomson, Co-editor-in-chief

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