More Than a Headache: Understanding Migraine at Midlife

Resources:

• American Migraine Foundation
  • American Migraine Foundation: Why Don't We Use the Terms "migraines," "migraine headaches" and "migraineur"?
• Canadian Headache Society
   

In this episode of The Positive Pause®, host Claire Gill speaks with Claire Sandoe, MD, MSc, neurologist, educator, and American Migraine Foundation board member, for a discussion about migraine’s impact on women, especially during key hormonal transitions like menopause. Dr. Sandoe shares clinical insights, recent research, and practical advice to empower women to seek help and break the stigma around migraine.

Dr. Sandoe is an Assistant Professor of Medicine (Neurology) at the University of Toronto and a headache neurologist at the Women's College Hospital Centre for Headache, where she directs the City-Wide Headache Medicine Fellowship. She serves on the boards of the Canadian Headache Society and the American Migraine Foundation, the Education Committees of the International Headache Society and the American Headache Society and is co-chair of the Canadian Headache Society National Neurology Resident Headache Course as well as the American Headache Society’s Mastering Migraine Therapies program.

Key Points Covered:

• Migraine is a brain disorder, not just a headache - Migraine can include a range of symptoms like nausea, light sensitivity, brain fog, and more, even between attacks.
• Hormones play a major role in migraine - Estrogen fluctuations during puberty, menstruation, pregnancy, and menopause significantly affect migraine patterns in women.
• One in seven people globally are affected - Migraine is common, especially among women (1 in 4) but still underdiagnosed and often misunderstood.
• Migraine attacks vs. migraine - Dr. Sandoe explains why language matters and how "migraine attack" better reflects the episodic yet serious nature of the disorder.
• Migraine and menopause - Perimenopause can worsen migraine symptoms. While some women improve post-menopause, others do not, and early treatment is key.
• Treatment options are diverse and evolving - From lifestyle changes and supplements (like magnesium) to cutting-edge medications (like CGRP blockers) and neuromodulation devices, a range of tools are available.
• Trial and error are part of treatment but shouldn’t mean suffering in silence - The right treatment often requires experimentation. Women should feel empowered to explore options without guilt or stigma.
• Stigma still exists - Migraine is often dismissed as “just a headache” or associated with outdated stereotypes of “hysterical women.” Raising awareness is vital.
• Migraine can worsen over time if left untreated - Dr. Sandoe compares it to a path in the brain, if traveled too often, it becomes a highway. Early treatment can prevent chronic, worsening symptoms.
• Resources are available - The American Migraine Foundation offers patient-friendly, clinician-verified resources on migraine, women’s health, and more.

Connect with the American Migraine Foundation (AMF):

• Website: https://americanmigrainefoundation.org 
• Facebook: @AmericanMigraineFoundation -- https://www.facebook.com/americanmigrainefoundation &