Sef

Some food for thought for me. I'm female and I started having migraines, chronic migraines (15+ days a month), and finally, clusters in addition to the migraines when I turned 34. Literally, the migraines started after my birthday and about 2 years in, I started getting clusters. My neurologist who I had been seeing for migraines was very reluctant to dX me as having clusters (female, migraine), but the clockwork 2x a day, 12 hrs apart, sharp icepick, and autonomic features plus the response to verapamil did it. (Edit: I had been screened for hemiplegic, idiopathic, stroke, MS, and carotid artery dissection before finally being dX as clusters.) Previously, I had had migraines before (that's what the doctor said, but when I think about it, he might have been wrong) which had started after a horrible ENT infection. I was 25, then, and I had it on a chronic basis before they just randomly disappeared after about a year. In addition to having clusters, I also have mood disorder (bipolar type II, mostly depressive) and have been treated for excessive daytime sleepiness as well. In both cases, my care team (neurologist, psychiatrist) have implicated circadian rhythm issues as a contributing factor for the headaches (pain and otherwise) and my neurologist implicated the hormonal changes in my body (perimenopause), weather changes (I'm a walking barometer, air quality analyst, and pollen predictor all in one), and histamine as three of the biggest causes for all of my headaches. I can faithfully take any and all useful maintenance or abortive medication, do a low histamine diet, keep my D levels up, try my best to regulate my circadian rhythm... But the hormones. The hormonal factor has made everything headache-related extremely resistant to treatment - triptans and CGRPs included, so yeah, I am and have been screwed.