|HER WORLD||Sunday, November 17, 2002, Chandigarh, India|
Why are women more susceptible to headaches than men? Contrary to early belief, this gender imbalance in headaches is not due to differing personality traits or societal standards. Rather, headaches are an unfortunate side effect of that essential female hormone, estrogen, says
A headache is usually referred to as 'a problem as old as man'. But, ironically, women suffer them more. According to womenshealth.com, a substantial "18 per cent of women experience migraine, as compared with 6 per cent of men". Simply put, women are three times more likely than men to develop a headache. In America alone, 23 million suffer from migraine, of which nearly 18 million are women; the scenario is similar in most other parts of the world.
"Until puberty, boys and girls are equally likely to have a headache. After puberty, female headache sufferers outnumber males. And their headaches are on an average more frequent and more severe than those experienced by men," states The American Council for Headache Education (ACHE).
Thanks to the new groundbreaking research on headaches the stale old joke about women, "Not tonight, dear, I've got a headache...." is now finally understood as simply a joke. "Headaches are not just in the head of a woman, or psychological or "hysterical" in nature, they are a real medical condition caused by real biological factors that need to be treated," says Indu Sharma, a general physician.
So, why are women more susceptible to headaches than men? Contrary to early belief, this gender imbalance in headaches is not due to differing personality traits or societal standards. Rather, headaches are an unfortunate side effect of that essential female hormone, estrogen. "Women don't get more migraines than men because women are more emotional and easier to upset," state Christine Adamec and neurologist Christina Peterson in their book The Women's Migraine Survival Guide: The most complete, up-to-date resource on the causes of your migraine pain - and treatments for real relief'.
Differences in hormones and genes and their effect on brain bio-chemicals probably account for the higher incidence of headaches among women. Hormonal changes that occur with puberty, the menstrual cycle, pregnancy, childbirth, breastfeeding and menopause are known to affect or trigger headaches.
"The genes that predispose people to developing headaches are probably equally present in men and women; whether or not they get expressed has a great deal to do with whether cycling hormones are around," explains Elizabeth Loder, director of the Headache Management Programme at Spaulding Rehabilitation Hospital in Boston.
While the primary role of estrogen is to maintain the female reproductive cycle, the hormone has access to virtually all tissues of the body and exerts widespread effect, particularly on the brain. Estrogen can directly influence nerve cells, alter brain chemicals, and affect blood vessels inside the head.
"Hormonal imbalances translating into headaches is actually very common," says Mridula Chichra, a Delhi-based gynaecologist. According to her, most women with menstrual migraine do not necessarily have hormonal abnormalities. "Rather, they have a biological predisposition to migraine, and the normal changes in hormones over the cycle serve as a trigger. Shortly before and during menstruation, the blood levels of estrogen drop significantly and this results in blood vessels dilation in the head with headaches."
When estrogen levels are low, the levels of serotonin also dip; low serotonin promotes headaches, perhaps by reducing the effectiveness of endorphins or the natural painkillers. Some women also experience migraine at ovulation—about mid-cycle—when the estrogen level drops. General Pre Menstrual Therapies (PMS) recommend that alcohol be avoided, and the level of blood sugar be stabilised. Women on oral contraceptives (OCs) or Hormone Replacement Therapy (HRT) are more likely to develop headaches during the time of the month when they are taken off estrogen. How OCs influence migraine is still unknown but because of the relationship between estrogen levels and migraine, OCs may have a significant impact on women. It has been observed that some women with severe migraine get better because of the regulation of the menstrual cycle and a stabilisation of hormonal fluctuations. At other times, women who have never suffered from migraine develop it as its side effect of OCs.
Therefore, women who suffer migraine and suspect OCs to be a trigger should use non-hormonal methods of birth control, at least until the headaches are controlled, or it is relatively certain that the OCs are not a contributing factor.
The peak occurrence of migraine in women is during the childbearing years. During pregnancy, migraine improves in 70 percent of women; in others it can begin, or worsen. Headaches sometimes return after a woman has given birth; again, changing estrogen levels may be to blame. Managing migraine during pregnancy and breastfeeding can be problematic, says Chichra. "Generally non-drug treatment is preferred. Avoidance of triggers, especially dietary ones, helps. Exercise, biofeedback and other relaxation techniques are good options."
Fluctuating hormones can also lead to headaches before or during menopause, along with the usual symptoms—hot flushes, night-sweats, insomnia, or irritability. And women who have had their ovaries removed are more likely to suffer migraine, or suffer worse headaches. However, once a woman is through the perimenopausal years and into menopause, the hormone levels stabilise and usually migraine improves. Cases of headaches related to menopause—before or during—are best managed through individual consultations with your doctor. Significantly, following natural menopause, there is a reported 60 per cent decrease in headaches.
There are many other factors to headaches among women. But, as Sharma explains, headache triggers do not 'cause' a headache. Instead, triggers activate or bring on a headache in a headache-prone person. The lack of sleep, altered sleep-wake cycles, and general stress are also common triggers. Others include environmental factors and weather patterns - heat, humidity, sudden changes in barometric pressure, dust, smoke, glare and strong odours. Women are particularly prone to insomnia and the headaches brought about by insufficient sleep.
And then there are food triggers too. Stress is by far the most common headache trigger. Refuting earlier suggestions that headaches are related to a particular personality pattern, researchers have now collected over 200 scientific studies examining the personality and behaviour of headache sufferers. These prove that there is no good evidence for a particular headache-prone personality.
Headache sufferers however, tend to have increased daily stress, more difficulty in coping with stress, and more mild symptoms of depression.
Probably, this explains
the highest prevalence for migraine in women between the ages of 35 and
45, when many women are at the height of their professional career,
family responsibilities, and social life. "Women often overextend
themselves, juggling many different roles and responsibilities, which
leads to stress", says Omesh Kashyap, a senior consultant
psychiatrist at the Vidya Sagar Institute of Mental Health and
Neurosurgery (VIMHANS), Delhi. While the impact of headaches on people's
lives cannot be underestimated, or the need for careful medical
evaluation and treatment ignored wherever appropriate, women - and men -
can certainly take the first important step. Says Dr Kashyap,
"Educate yourself about the headache, its causes and treatment and
then make informed decisions about the kind of treatment that will work
best for you."
Tough life, tougher women
A majority of hill and tribal women lead a life that is poverty-stricken and overburdened by domestic chores that have to be performed from dawn to dusk. They are forced to take up whatever employment is locally available in hill and tribal areas of Himachal Pradesh. In this hill state, female population contributes about half of the total population. It is generally believed that the contribution of hill and tribal women in economic development is negligible because their domestic chores have not been economically evaluated. There are several tasks at home which can cost a lot of money to the family if they are not performed by women.
The hill woman gets up in the early hours and starts her domestic daily routine. She completes her work of cleaning the house, preparing milk products, cooking food and cleaning of animal sheds before the day dawns and the other family members get up. She milks the cattle. Then she offers food to the other family members and sends the male members to their job and children to school. The onus of attending old and sick people also lies on her. Afterwards, she goes out to collect fodder and fuel wood, before going to the fields and where she remains busy throughout the day.
After eight to nine hours of arduous work, she returns home and attends to households chores and needs of the children without rest, who are left in the charge of elderly grand parents throughout the day. She feeds and milks the cattle. Even at night when she is fully tired, she remains busy in tending the children, washing of clothes and churning milk etc. This struggle keeps her physically fit, mentally occupied and self satisfied. In spite of excessive labour, she remains cheerful and can often be heard singing while working.
Among all the agricultural operations performed in the fields, hill women have a pivotal role in the seed bed preparation, levelling, clod breaking, sowing, transplanting, intercultural operations, manuring, watering, harvesting, threshing, winnowing, drying and storage.
During the lean period, the hill women collect fruits like amla, ber, and mushrooms from the forests along with grass and wood. The forests are their source of sal seed, colocasia, amorphophphallus, wild dates, honey and many other valuable products and medicinal herbs. Some women also gather buds and flowers of kachnar (Bauhinia spp) and raw fruits of figs for vegetable purposes and taur and siali leaves to make patravali (local plates) and sell them in the market. The tribal women of Kinnaur and Lahaul and Spiti collect different mushroom species, kala zira and chilgoza seeds from the forests besides grass, wood, and some medicinal plants. During snowfall in winters, the women engage themselves in various indoor activities like cleaning of wool, spinning, weaving and stitching of their warm clothes like shawls, blankets and patti etc.
level is the major constraint of the hill and tribal women making them
handicapped in most of the workfields. The roads in these areas are
not developed properly and women have to walk paths that are no more
than goat tracts for long distances carrying loads of water, grass and
fireworks. Inaccessibility to these areas also hinders the efficient
working of various extension agencies engaged in their uplift. In most
of the cases, tribal society has polyandric and polygynic system of
marriage which is a major social constraint coercing women to stick to
their low social and economic status, despite their hard work.
Training of hill/tribal women in respect of improved agricultural
practices, seed selection, insect pest and disease management and
storage is imperative to enhance their efficiency and to reduce
drudgery. Women should be direct recipients of the extension services
of the community. Innovative participatory methods of imparting
improved technology should be designed and made available through
village extension workers and officers.
IRAN'S first female bus driver has taken to the road in a small victory for gender equality that has already forced men to take a back seat. Seating on Iranian buses has been segregated since the 1979 Islamic Revolution, with women forced to sit at the back so that they do not distract the normally male driver. But on Masoumeh Soltan-Bolaghi’s bus, the seating order will be reversed for the same reason. Official news agency IRNA said university graduate Bolaghi had taken to the wheel in the city of Karaj, about 40 miles west of Tehran. IRNA quoted Bolaghi as saying she hoped her example would have "a positive effect on women’s morale’’. Iran started its first women taxi driver service earlier this year in the holy city of Qom. But the women drivers are only allowed to pick up female passengers.
Infidelity in the genes
Women with steady partners may still be tempted to sleep around—but mainly on certain days of the month, say researchers. A BBC documentary explains how human sexual instincts are so strong that some women's preferences may alter significantly while they are ovulating.
While her partner might be a better bet to bring up children and support her, another man might carry genes which mean healthier, stronger children.
Morgan Wise, a train driver from Big Spring in Texas, found this out when his youngest son was found to have cystic fibrosis, a devastating lung disorder caused by a single faulty gene. Morgan Wise found he had fathered none of his sons
Both mother and father must carry the gene to produce a cystic fibrosis child, and Morgan duly went for a gene test to confirm he was a carrier. The test proved negative - effectively proving that he was not the child's father.
He told the BBC: "The doctor said: 'You are not a carrier of cystic fibrosis." I couldn't believe it."
There was worse to come. Subsequent DNA tests revealed that not one of Morgan's three sons was fathered by him.
However, researchers suggest that this is by no means an isolated event. One study suggested that one in 10 children are being raised by men who are unaware that they are not the father. A more "masculine" face was found to be better during fertile period. A study at the University of Stirling seems to pinpoint the instinct which might tempt some women to stray around the time of the month they are fertile. Two groups of female volunteers were picked.
One was tested during their ovulation, the other at another point in her cycle.
Each was shown a computer image of a male face which they could adjust electronically to make appear more or less masculine, using features such as the thickness of the neck and the squareness of the jaw.
While the group not ovulating tended to prefer their men with slightly more feminine feature, at the point of ovulating the women strongly preferred their men masculine.
This, say scientists, is down to instinct - while more feminine features might signify a man with less testosterone who is more likely to prove a steady partner, the stronger features they preferred at ovulation might indicate a better set of genes, thus producing a stronger or healthier child.
No to diamonds
In the digital age, a diamond is not a girl's best friend. A high-definition television set is.
After interviewing 1,000 men and women, the Consumer Electronics Association found that 58 per cent of women would prefer to own a HDTV set than a 1-carat diamond ring. CEA's study, which was released some time back, said that 64 per cent of women would rather have a digital camera than a pair of half-carat diamond stud earrings. The study confirmed that women like digital toys just as much as men, who are generally believed to be the main purchasers of electronic gear in the home, said a CEA spokesman.
"Female consumers spend approximately $55 billion each year on consumer technology products," said Sean Wargo, director of industry analysis for CEA. "That's nearly half of the total consumer electronics market. And with these survey results showing a significant portion of women saying they are now more confident in purchasing electronics, we can only expect their collective buying power to increase as well."
In fact, women expressed a high level of interest in certain items that are traditionally popular with men, like colour TVs (63 per cent) and digital cameras (43 per cent), CEA's study stated.
Women also own more consumer electronic goods than ever before: Twenty per cent of women own a lap-top computer, whereas only 12 per cent did in 2000. Nearly two-thirds of women own a cell phone, while 49 per cent did two years ago, said CEA.
Women initiate almost half—49 percent—of all electronics purchases, the study concluded.
Scientists have proved what many have long suspected—the very presence of your spouse can be a pain. By eavesdropping on electrical activity in the brain, researchers investigating the effects the effects of chronic pain found that a husband or wife can make a pain three times as worse by just being in the room. All they had to do to make their spouses feel better, the neural probes revealed, was leave. And it was the most solicitous husbands and wives - those who clucked most lovingly over their spouses discomfort - who triggered the pain.
The new research, reported at a meeting of 24,000 neuroscientists in Orlando, Florida, offers the first clear neural evidence that social experiences can directly alter the way in which the brain responds to chronic pain.
"For the first time, we have discovered that a social variable, namely the presence of a spouse, can influence the brain’s response to pain," said Herta Flor, a neuropsychologist at Germany’s University of Heidelberg, who led the study team.
The work is part of a cascade of provocative insights into how experience can alter the structure and responses of the brain.
It shows that neurons and neural circuits are constantly remodeling themselves to accommodate experiences - whether the stimulation of computer games, too much stress, or the actions of an overly sympathetic helpmate.
Dr Flor and her colleagues studied 20couples in which one partner suffered from severe chronic back pain. They monitored the patient’s brain activity with electrodes and then gave painful electric shocks to their aching backs and studied the responses. The more the husbands or wives dwelt on their partners’ pain, the worse it felt, the neural monitors showed. Spouses who responded to pain complaints by changing the subject, by suggesting helpful but distracting activity, or by not dwelling too long on the pain, did not have this effect.
"When people pay too much attention to another’s pain, it tends to reinforce that pain," Dr Flor said. "We forget to reinforce those things that are not pain-related, like when a person smiles." She suggested that the treatment of chronic pain should involve husband and wife together, so they can focus on things that counteract the discomfort.
— www.weridnews.com and Los Angeles Times
any situation to point of no return’
SHE binds two centuries together, and holds four generations in continuity like a thread between a distant past and today. Beeji Kartar Kaur was born in 1911, to Punjab’s eminent lawyer, politician Sardar Bahadur Buta Singh, who represented the Sikhs twice at the round table conference and had the privilege of ‘trouncing’ Churchill in a dialogue, according to the British Press. But for her two sons (one a retired Air Marshal and the other a retired Lieutenant-General) a vivacious 71-year-old daughter and the numerous grandchildren and great-grand children, who belie her age, she would well pass off as 20 younger than her age. Talking to her was like reliving an era goneby. She is a treasure-trove of information on Punjab—be it people, places or history. From experiencing the sight of the first electric lamp, to riding the first car in Shekupura, Kartar Kaur has traversed the 20th Century to the 21st era of computers, racing cars and degenerate human values. She talks of her life to Teena Singh.
What is the secret of your excellent physical and mental health?
I have kept up my interest in life. From reading to cards to moires, to conversation. Even when I am alone, I play scrabble.
What are the earliest memories that you have?
I remember being severely reprimanded for objecting to my mother talking to a weaver’s wife in the neighbourhood because I found her ugly and poor. Neighbours were family. No one was divided by race, looks or financial status. One’s own culture showed in accepting all — irrespective of their religion. The other sharp memory is how my father was sitting in a lungi and slippers after washing his hair and how suddenly the police walked in to arrest him in 1919. Patriotism was a common factor that bound all homes.
What was responsible for making your marriage a success?
We were married for 57 years and we both trusted and respected each other. He did not curtail my exposure to life, I respected his wisdom. We were one voice in all aspects of life.
I was four months short of 16 years when I married a man who was 23 years my senior. Until then, I had embroidered four phulkaris, helped my mother bring up seven siblings. All us sisters helped in the household. We were taught to respect and obey our parents and elders without exception. We were mature, without being promiscuous.
Three generations peacefully co-existed in your house...
Everyone wished to show wisdom and intelligence through restraint, respect and adaptability. What the husband said was a rule, the wife’s wish was a command, the father was obeyed and the mother was wise.
While my mother followed all traditions and customs and was extremely hospitable, my grandma would sit on a raised platform everyday with wheat and flour for the Muslim and Hindu fakirs, sadhus and beggars. Even begging had rules. All came before 12 in the afternoon.
How was the lifestyle those days?
Cloth fans used to be pulled by servants. One big room was the lamp room. One man was in-charge of cleaning, oiling and lighting lamps every evening in the house. The first light put in the town was accompanied by a big party and celebration, we too put a light in our house later. My father owned the first car in town and it came all the way from Delhi with a driver. The car agents used to supply the drivers too. My father was a leading criminal lawyer but those days cases were fought on facts, without harassment or bias. Anyone coming to Shekhupura stayed and ate in our house — irrespective of law cases, relationships etc. In fact, in one instance, my father was fighting a case and the woman who was the opponent came and stayed in our house.
There were a few exceptions, but most of us felt proud of our Indian ways. It is funny how, we were more Indian under the British compared to a very westernised society in free India today.
How do you cope with changing values and morals ?
I lead my life according to my faith and belief and leave my children, grand children, great-grand children to their devices and convictions.
The mool mantra
for peaceful co-existence is be and let be. Always forgive and forget.
Don’t push any situation to a point of no return. Ego, pride,
feelings, all must be used or curtailed to save relationships and
situations. The changing face of politics and decline of honesty,
integrity fills me up with disgust.