Cutting off my own head is not something I normally fantasize about, but last week in the grip of a migraine, decapitation seemed like the only logical way forward. It has been about a year since my last migraine and last week I had two. I hope it’s not going to become a trend.
This throbbing, intense, one-sided pain behind one eye is often accompanied by nausea, vomiting and extreme fatigue. When I have one I can’t do anything other than lie in bed for the rest of the day, and there is an intense hangover-feeling the next morning. And it always comes on during or immediately after a run: exercise-induced migraine.
It starts when I least expect it. I’ll be out in the woods on an easy run, thinking about nothing in particular, when suddenly I notice a blind spot like a hole in my vision. If I look at a person, they may have only one eye, or be missing the whole right side of their face. The surroundings may start to look like this:
The blind spot lasts for 10-15 minutes and is followed by a flickering curlicue line across my vision, which slowly expands to become a blurry patch with colorful edges that takes up almost my entire field of sight. This is a full-blown migraine aura, and it’s so unpleasant that I get nauseous even just writing about it! By this point, I can hardly see anything. If I don’t do anything to stop it, the aura will last for about an hour. Then the pain and nausea start. All I can do is take ibuprofen and sleep.
I had the aura/migraine problem on and off for years, but only very occasionally, maybe once or twice a year, and often just the aura with no pain. Every time it happened I would vaguely think I should go to the doctor, but naps made it go away so it didn’t seem like medical intervention was necessary. Then during the first year after I had my son it got really bad. I had phases during which I’d get a migraine aura every time I ran, either during or after. Sometimes these developed into bad headaches, sometimes not. I even had a couple episodes, complete with vomiting and pain, that were so bad I seriously wondered if I was dying.
After weaning my son and regaining my period, I realized the migraines, or sometimes just the auras, always happened during the week before my period. Womanhood! Truly the gift that never stops giving! Awesome, right? But why?
Well, I’m no doctor, but it turns out that right before your period starts, your estrogen levels drop dramatically. Clove has explored all the ways in which this affects running (spoiler: none of them are good), and we can add one more to the list, because the change in estrogen levels is also associated with migraine pain. And although I didn’t even menstruate for most of my son’s first year, birth, breastfeeding and weaning all involve hormone shifts, which likely explains why it was so bad.
So what can we do about it?
When I went to the doctor she was phlegmatic, prescribed a triptan-family migraine medication and suggested not running if that was what brought it on. Not running! Ha! Very funny. But she was essentially following two standard plans of attack for migraines:
Medication: Unfortunately the prescription medication never worked for me (though it may for you); it was all side effects and no pain relief. I went back to ibuprofen, which at least makes it bearable, and I started surfing to research on my own. Although studies remain inconclusive on whether or not hormonal supplements definitely help, recent articles like this one still harken back to a 1984 study that lead its authors to believe estrogen can take over sympathetic control of blood flow to your brain, which means that controlling your estrogen could very well help control your migraines.
Avoiding Triggers: Some people have migraines when they’re stressed, or exposed to bright light, or when they’ve eaten a certain food. If your trigger is running with PMS, should you just not run or exercise for 7-10 days a month? That’s a question only you can answer. For me, the benefits of running (ie, mood therapy) are enough that the chance of having a migraine isn’t enough to deter me. Instead, I focus on…
- Eating or drinking something sweet can make the aura disappear, so try to have a gel with you during PMS week in case the aura starts mid-run. No gel? Take along some change to buy a cola or some chocolate (it’s the perfect excuse).
- If you use medication, stash a couple doses anywhere you might need it, like your car, your gym bag, or at work.
- Run close to home so you don’t get stuck in the middle of the woods, six miles from anything, in case a migraine sets in.
- If you feel a migraine coming on, stop running. Turn around and head home as soon as possible.
Some say caffeine can also help. Caffeine is a vasoconstrictor, meaning it restricts blood vessels, which may help ease migraine pain, and it also can help make pain medication more effective¹. But as you know if you drink coffee and have ever skipped a day, caffeine overuse or caffeine withdrawal can also ², so it’s important to be careful using it and to know your boundaries. Personally I’m not convinced, but I’ll try anything if it might work, so sometimes I’ll have a coffee along with my migraine.
The key to minimizing my migraine pain is to drop everything as soon as it starts, get some sugar in me, take my ibuprofen, and lie down. If I do this, I’m still out of it for the rest of the day, but at least I won’t end up wishing fervently for decapitation. If I don’t and stubbornly continue my run or try to keep up with daily life activities because strong women don’t ask for help…well, let’s just say it’s not worth it.
Do you get migraines while running, or do you have different triggers? Which treatment options work for you? Share your experiences in the comments!