Jenn S., 38, has been living with migraine since she was in sixth grade.

“It’s a tremendous amount of pain, but it’s so much more beyond that,” Jenn says. Migraine symptoms vary, but for Jenn, they can include searing pain so intense it leads to nausea and vomiting, sensitivity to light and sound, distorted vision, and aphasia — a temporary disruption in the ability to find words and express language clearly. 

Migraine is a neurological disease that affects an estimated 40 million Americans. It is three times more likely to occur in women than men and is the leading cause of disability among women under age 50 worldwide. A 2025 report estimates closing key gaps in women’s health care, including migraine management, could boost global GDP by $400 billion by 2040. 

Turning pain into purpose

Jenn has chronic migraine, meaning she has some level of head pain more days than not. Like many women with migraine, attacks around menstruation tend to be particularly severe and less responsive to treatment for Jenn. 

Even on days when she is feeling well, Jenn wonders when migraine will incapacitate her next and how she can plan her life — her career and quality time with her husband and five-year-old daughter — around severe attacks. 

“Migraine is basically the biggest factor in any decision that I make,” Jenn says. “It controls what I eat, when I go to sleep, [and] what activities I do.” 

She also has had to factor migraine into big life decisions, such as whether a job she wants offers enough flexibility for her to manage bad migraine days, if a promotion might add too much stress, and whether expanding her family would be possible.

“At one point, I was feeling super frustrated and unsure of what I could really do,” Jenn says. “And I think it’s in those moments that you kind of have to find a higher purpose.”

She found that purpose in advocating for increased access to treatments for migraine through the Alliance for Headache Disorders. Each year, during Headache on the Hill, Jenn joins people living with headache disorders from across the country to meet with legislators and advocate for funding and improved policies impacting the millions of Americans affected by these conditions.

Jenn’s advocacy has taken on additional meaning recently, as her daughter started experiencing migraine attacks. 

“I really love the community and the feeling that I can do something and be a voice for myself, others, and my daughter, to hopefully create a better future for those of us that live with headache disorders,” Jenn says. She hopes advances in the research will allow her daughter to live with less pain and more freedom than she’s experienced.

“Any time I blow out a candle or make a wish, it’s always about migraine,” Jenn says. “My daughter doesn’t even have to ask me, ‘What are you blowing out your candle for? What’s your wish as you blow off the flower petals?’” Jenn is always wishing that her daughter doesn’t need to suffer like she does, and that advancements for migraine are made. 

The connection between migraine and women’s health

Among people with migraine, women tend to experience more frequent and longer-lasting migraine attacks compared to men, and the frequency and severity of migraine varies throughout the stages of a woman’s life. At puberty, once a woman begins menstruating, the prevalence of migraine in females rapidly escalates. 

The disproportionate impact of migraine on women is largely attributed to hormonal differences. “It’s not the absolute levels of hormones, but more the fluctuations in hormones that cause migraine attacks,” explains Chelsea Leroue, medical director on the migraine team at Pfizer. “For example, a drop in estrogen is thought to trigger migraine — this occurs in the days prior to the onset of menstrual bleeding each month or during perimenopause.” 

Estrogen influences the nervous system, and recent studies have found that estrogen can alter the release of certain chemicals, like CGRP, a protein that is elevated during migraine attacks and contributes to pain and other symptoms. Despite recent advancements, more research is needed to better understand why and how women experience migraine differently. 

In her role at Pfizer, Chelsea works to help improve migraine diagnosis, screening, and education through increasing awareness among healthcare providers and the general public, some of whom may have the condition without realizing it or lack awareness that treatments are available.

There is a need for more migraine awareness and education among health care providers, too. There are only about 800 certified headache specialists in the country, Chelsea notes, compared to the roughly 40 million people living with migraine. 

“We estimate that about half the people living with migraine have never been diagnosed. Many women, for example, know their periods are associated with bloating, cramping, and other symptoms, so adding headaches to the list is just one of several unpleasant things that they grin and bear during that time,” Chelsea says. “Unless you are in the care of a well-informed provider or you’re educated on migraine and the potential hormonal association, you don’t realize that those headaches may actually be migraine headaches.”

Chelsea’s passion for raising awareness about migraine is both scientific and personal.

“I can still remember the very first attack that I had, which was in middle school,” Chelsea says. “Unless you’ve experienced migraine attacks with symptoms like severe headache, nausea and vomiting, and extreme sensitivity to light and noise, it’s hard to fully understand how debilitating this disease can be.”

Giving voice to an invisible disease

Jenn visited Pfizer’s office in Collegeville, Pa., to meet Chelsea in person and discuss the disease that has played a large part in their lives in different ways. To open the conversation, Jenn read a letter she’d written to Chelsea about the impact of migraine, and the complications of such an invisible disease, on her life. 

“I have spent years defending my reality,” she read. “I have never once faked being sick, but I have faked being well.”

Jenn closed the letter with questions for Chelsea, including why migraine disproportionately impacts women. 

“We’re just beginning to really understand the role that hormones are playing,” Chelsea explained. “It’s just now, in the last few years, that we’ve uncovered that estrogen receptors are in those brain regions that are responsible for migraine attacks. But given how hormones are fluctuating over the course of a lifespan, migraine presents differently at different stages of a woman’s life.” 

Jenn followed up by asking what it might be about her brain that makes her attacks so severe. 

“I wish we had a solid answer to that, but that’s what makes it so motivating to do the work that we do in migraine,” Chelsea said. “Science is really advancing in our understanding of migraine, but one of the things that makes migraine really challenging is the fact that no two people with migraine are the same.”

Jenn nodded in agreement. “I know that this is hard work, especially in a space in which migraine impacts everyone so differently,” she said. “I really appreciate the understanding and the recognition of this varied disease and all of the tremendous work that you’re putting in to make sure that we can get to a brighter future for patients like me.”