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MEDIZIN ENGLISH BE A MAN, ACCEPT HELP An inside look into a life with migraines Migraine is a serious neurological disease. Those affected not only suffer from severe headaches and other side effects, but are also extremely restricted in their everyday lives. While about 15.6% to 23.9% of women are affected by migraines, the incidence in men is only 4.0% to 11.1%. So what is it like for men to deal with this "women’s" disease? Foto: wayhomestudio / Mehmet Ç. is married, a father of two and is enjoying his managerial role in the telecommunications industry. The 42-year-old has suffered from migraines since childhood. “Even as a boy, I often complained about headaches. It was particularly sad for me when it meant that I had to give up my favorite hobby: martial arts.” He also had to take sick leave more often at work and had to live through up to 20 migraine attacks a month. Migraines are very diverse and the triggers are different for each person. With Mehmet, the pain attacks are often announced with word-finding disorders and pressure or stinging in the neck. He has learned to know exactly what influences his illness both positively and negatively: “When I have a lot of stress or sleep too little, I notice that it is not good for me. Even if I eat or drink too little, it can trigger an attack.” In his private life, the trained sales coach has not yet had any bad experiences with his particular illness. He is met with understanding and great support, especially from his family. MIGRAINES AND MASCULINITY – NOT A CONTRADICTION According to the Journal of Health Monitoring, migraines affect more women than men. Is it therefore still difficult (or more difficult) for men to "come out" as migraineurs? Mehmet says: “I think it always depends on how you wish to be perceived. An open and self-confident approach to the subject will certainly make things easier for those affected, regardless 54 CHECK OST #2

MEDIZIN of gender. ”However, inventing excuses or hiding the disease definitely does not lead to anything, except for stress and tension. That alone can lead to migraine attacks – so it is not a solution. Nevertheless, Mehmet also knows that it takes a lot of courage to do this. As such, he wants to encourage other men to be open about their migraines. What does the neurologist say? NEW THERAPY BROUGHT RELIEF In the summer of 2019, his neurologist started a new treatment for him, the so-called migraine injection, an antibody therapy. A real life changer! “The change was really phenomenal and I'm not exaggerating. Already after the first injections I started to see improvements,” says Mehmet. The first five injections of the antibody therapy were given to him in the neurological practice, after which he was able to inject the drug himself – similar to diabetes. With this therapy, his pain has decreased significantly. The pressure and stinging in the neck as well as the speech disorders are still there, but the unbearable pain is contained. The number of days on which he has attacks has also decreased significantly. Now he only gets around six to eight attacks a month. "That is a clear relief for me," he says. DO MEN NOT SUFFER? There is a common misconception that one can’t complain about migraines as to get through this extreme pain you have to be "a tough guy", regardless of gender. “I'm generally a very open person and personally have no problems talking about it. I stand by the migraines,” says Mehmet. “I also advise other people affected to deal openly with the disease. After all, migraines are serious illnesses that should be recognized. Men are also allowed to accept help and proactively ask for support. Every step you take forward can be the right one." (red,mb) Dr. med. Astrid Gendolla, specialist in neurology with an additional qualification in special pain therapy and psychotherapy with her own practice in Essen. Does migraine appear differently in men than in women? „No. In general, the symptoms (such as headache worsening depending on movement) and optionally the accompanying symptoms are the same in men and women.“ Are men more likely to shy away from seeking medical help for migraines? “There are gender-specific differences in the extent to which doctors are consulted. In general, migraines are still perceived as a “women‘s” disease – the gender ratio here is 1:3. Epidemiological data also support this thesis. In families, mothers have migraines more often, so the family ascription is more aimed at women... When men wake up on Saturdays with a headache, they first think of the previous evening as the cause and less of a „real“ migraine. But vice versa, some doctors certainly do not think of the diagnosis „migraines“ when a man introduces himself to them as a patient with a headache.“ CHECK OST #2 55

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