Understanding the unique needs of transgender people with migraine to provide better treatment

Over 36 million Americans live with migraine, and different populations have different treatment needs and experiences. For transgender people living with migraine, less is known about migraine’s effects and potential obstacles to finding effective treatment. Headache specialists like Barbara Nye, MD, Co-Director of the Headache Center at Dartmouth, are working to improve the field’s understanding of migraine in transgender people and provide more comprehensive treatment options that reflect the unique needs of this community.

Migraine Treatment for Transgender Patients

Migraine treatment for transgender patients closely mirrors treatment best practices for cisgender patients. In all cases, doctors will work to identify individual symptoms, triggers and lifestyle habits to find the best solution for every unique patient. It’s important for transgender migraine patients to know that they don’t have to choose between persistent, debilitating head pain and hormone therapy. Many preventative treatments won’t interfere with hormone therapy. But because certain migraine treatments may be contraindicated for patients taking hormone medications, it’s important to be honest with your headache specialist about any medications you may be taking. Doctors can factor in hormone levels when working with patients to find treatment plans.

Gender, Hormones and Migraine

Much of the conversation about migraine and gender stems from the influence of hormones. Migraine incidence in children is similar in boys and girls, but after puberty, women are three times more likely to have migraine than men. Fluctuating hormones are thought to be the reason for this difference. Dr. Nye says patients undergoing hormone therapy often maintain more consistent estrogen levels than women not undergoing hormone therapy, which can reduce migraine symptoms and attacks. The more information you can provide your doctor, the better he or she can devise a custom treatment plan that meets your needs and helps improve your migraine.

Tips for Seeking Treatment

The first step to finding the treatment and care you deserve is to use our Find a Doctor tool to locate a headache specialist near you. A headache specialist is a critical part of your migraine support team, and finding a compassionate, LGBTQ-friendly provider you feel comfortable with is a huge step forward. It’s up to the patient to take initiative in connecting different providers and granting permission for them to share information, Nye said, which is important so that your medical team is on the same page and can synchronize your treatments.

Once you’ve found a headache specialist, communication is the key to finding the right treatment plan. Your doctor will ask open-ended questions and listen to your circumstances, needs and concerns. To get the best treatment, be honest with your providers, and disclose facts about your transition when necessary. Nye notes that for transgender patients, sensitivity surrounding their transition can impede an open discussion about possible side effects of hormone therapy. Hormones may affect the way transgender patients experience migraine, so it’s important to work with your doctor to understand potential medical risks and find alternatives if needed. No one will make you stop hormone treatments: what they can do is prescribe a migraine treatment plan that accommodates your existing medication regimen.

Migraine is different for every patient, and finding the right doctor is essential to getting a proper diagnosis and a treatment plan that works for you. Search our online doctor database to find a headache specialist near you, and read more about living with migraine in our resource library.