Migraine and Women in the Workplace

How to balance migraine and a successful career

Migraine is a disease that affects about a billion people worldwide and is three times more common in women. Of the more than 37 million Americans who are living with migraine, 28 million are women. Studies have also shown that women experience migraine differently from men and that they may have longer-lasting episodes.

Migraine can cause problems for women in their professional lives if it is not properly managed. By understanding migraine and self-advocating in the workplace, women can address migraine and prevent it from affecting their careers. 

How Migraine Affects Women
After puberty, women are two to three times more likely to experience migraine than men. The exact reasons for this are not clear, but researchers suspect that fluctuating hormone levels play an important role.

Dips in estrogen levels cause more frequent, intense attacks in women who already experience migraine, and fluctuations in a woman’s estrogen levels as she progresses through different life stages can cause migraine onset and affect their treatment options.

There are ways to help reduce or prevent headaches in women whose migraine has a strong hormonal component, according to Shamin Masrour, DO, of the University of Texas Southwestern Medical Center, although none are FDA approved.

Masrour says women with predictable migraine headaches can start the use of daily nonsteroidal anti-inflammatory drugs (NSAIDs) a few days prior to menstruation and through its duration, and that some women find continuous hormonal contraception may also avert menstrual-related migraine by preventing the inevitable drop in estrogen that occurs with the pill-free week.

Women with migraine (especially those who experience an aura) need to discuss the use of estrogen-containing medications with their physicians, as it may increase their risk of stroke.

But while these treatments can be helpful for some, they are not surefire strategies for everyone. For professional women, it may be necessary to turn to their employer for help making the office less triggering for their migraines.

Accommodating Migraine on the Job
In America, over 113 million workdays are lost due to migraine every year. One of the most challenging aspects of living with migraine is the disease’s invisible nature — especially when it comes to managing a career. Because the colleagues of a patient with migraine often cannot see a physical manifestation, it may be more difficult for them to understand.

But migraine doesn’t have to mean the end of your professional life. Dr. Elizabeth Leroux, of the University of Calgary, has a four-step process for pursuing accommodations for migraine in the workplace:

1. Know your migraine. Take inventory of the situation by identifying what type of migraine you have — episodic or chronic — and how that impacts your life. Leroux then suggests defining any goals you have, like being able to continue working full-time or, if necessary, applying for disability. Only once your goals are established can you identify the steps needed to achieve them.

If you do opt to continue working full or part-time, look around your workplace and suggest reasonable accommodations for your migraine. Triggers can include bright or fluorescent lights, loud noises, and strong odors such as perfumes, candles, and air fresheners.

“Workplaces are filled with potential triggers for migraine,” Leroux says. “The brain interacts with the environment, so it can be affected by a co-worker who wears very strong perfume.”

2. Identify reasonable accommodations. Once you identify your migraine triggers, start a list of productive ideas to make you feel more efficient at work. Don’t be intimidated by your requests — a computer stand to facilitate better posture, for example, or a tinted cover to soften screen glare are relatively small accommodations to make the office more accessible.

“‘No scents’ policies are becoming more commonplace as employers acknowledge that strong scents can trigger migraine attacks — and even just be irritating for people without migraine,” Leroux says.

3. Assemble your migraine support team. Once you’ve identified your requests, make sure to lean on your healthcare provider and migraine support network to make your request in an effective way. Leroux says having a physician’s note can establish migraine as a disabling disease and lend credibility to your requests.

As soon as you have everything you need to demonstrate what you are going through and how your employer can help, you’re ready to meet with them.

4. Start the conversation. Schedule a meeting with your employer. Enter the discussion with an open mind, Leroux says. Put yourself in the employer’s shoes, and frame requests based on productivity and on being the best employee you can be.

“The employer has to manage the workforce and their employees, so you have to present reasonable accommodations in a reasonable tone,” Leroux says.

It’s also possible that your employer has no idea what migraine is, so approaching your meeting with the intention of educating them is important.

Overcoming a Professional Obstacle
Gender is a key factor in migraine expression and treatment, with women’s symptoms often fluctuating substantially throughout the stages of their lives. The disproportionate way that migraine affects women means they are statistically more likely to face problems in the workplace because of it.

But knowing how to fight migraine and understanding how to advocate for yourself in the workplace can make this condition more manageable and keep it from being a roadblock to professional success.  

Contributed by The American Migraine Foundation, which provides education, support, and resources for the millions of people living with migraine. For more information, please visit www.americanmigrainefoundation.org. Together we are as relentless as migraine.