"Throughout her early s Shirley Kessel ran through a gamut of medications but none brought relief from her daily migraines. Special occasions werent spared On her wedding day Kessel suffered the worst headache of her life. I couldnt wait for the day to end said Kessel who now is  and executive director of Miles for Migraine which raises money for research and education for the disease. Finally during her first pregnancy the chronic headaches abated. After the birth of her first daughter Kessels headaches subsided to one or two menstrual migraines per month. For years she got relief from triptans a fastacting class of drug developed in the s for migraine attacks. During perimenopause however her chronic headaches returned along with fatigue nausea light and noise sensitivity and ringing in her ears.  Migraines affect an estimated  million Americans httpmigraineresearchfoundation.orgaboutmigrainemigrainefacts and about three out of four people who suffer from them are women. The World Health Organization estimates  million to  million people worldwide experience chronic migraine defined as  or more headaches per month over at least three months. Migraines also often have a genetic component. Along with her mother two of Kessels three daughters  Julia  and Sydney   suffer from migraines.  Sydney who is in college lost a year of high school to migraines which transformed her from an active social butterfly to a withdrawn and nauseated young woman who spent most of her time in bed. While a number of interventions exist many work only for a limited time. There are many medications for migraines  including topiramate antidepressants blood pressure medications and Botox injections. But there hasnt been a new drug specifically designed for migraines since triptans. Thats likely to change. A new study recently in the New England Journal of Medicine http reports that fremanezumab an immunotherapy drug has been found to reduce the number of days that chronic migraine sufferers experienced headaches. The drug blocks the activity of a molecule called calcitonin generelated peptide or CGRP which spikes during migraine attacks. By blocking this peptide doctors hope to break the cycle of increasing inflammation and heightened pain sensitivity that contributes to migraine headaches. Its the first specific migraine drug said Stephen D. Silberstein director of the Jefferson Headache Center at Thomas Jefferson University Hospitals and lead author of the study.  This therapeutic approach offers new hope for people whose migraines cannot be treated with existing medicine. Based on the promising phase III clinical trials the drug could be available later next year. Women get more migraines than men because of hormonal changes said Roderick Spears a physician and clinical associate of neurology at Penn Medicine. If you look at the statistics boys outpace girls with migraines until girls start to menstruate and you begin to have hormonal fluctuations said Spears. About twothirds of women with migraines will get some type of migraine around ovulation or menstruation. Its the cycle of rising and falling estrogen levels said Silberstein.  During perimenopause when periods and estrogen levels are irregular headaches increase. Stable estrogen is better for migraines. He notes that sometimes as was true in Kessels case the second or third trimester of pregnancy brings a drop in migraines. Because of the hormonal connection some physicians prescribe lowdose estrogen patches or try IUDs that are progesteronebased to stem headaches said Spears. Other women use antiinflammatories like naproxen sodium or a longacting migraine medication Meanwhile Silberstein suggests preventive measures for those with migraines. First and foremost regular exercise meditation or biofeedback he said. Then there are medications. Prevention can also include doses of CoQ  and riboflavin which have been shown to help. Another useful supplement is magnesium which has been clinically shown to prevent menstrual migraines said Spears. Lifestyle changes can also prove useful Spears recommends regulating sleep eating regular meals avoiding artificial sweeteners limiting caffeine intake and holding rescue medications to two days per week. As if the pain werent enough migraineurs as sufferers are known may also cope with stigma. Migraine in the th century had been considered a disease of neurotic women said Silberstein. But this is a neurological disease. Also some people have one attack every three months others have it every day. And if you have infrequent migraines it may not seem a big deal Silberstein said. And attitudes from the medical community may not help. I think this may be changing in health care said Spears but because migraine affects women more than men there is a stigma around the stereotype of a patient who comes in with multiple complaints calls frequently and wants to see the doctor frequently. Men on the other hand have been stereotyped as going to the doctor only when something he has is real. Another problem is that you cant see a migraine. If youre walking around with crutches or your arm in a sling you can see that but if you tell people your head hurts light bothers you or sounds bother you people dont really believe it Spears said.  Its hard for people to understand what migraineurs are really going through. These days Kessel who lives in Lafayette Hill struggles to weather her headaches and looks toward the future for a cure.  My lifestyle is not the same as other women my age she said. I may look completely normal. But thats not how I feel."