Heads Up

What does chronic pain really mean, and why can it feel harder to manage in midlife?

For World Menopause Day, our host Headache Specialist Dr Katy Munro is joined by Dr Barbara Phipps, a GP working with people living with persistent pain, to explore chronic pain at midlife.

Together, they discuss why pain can persist, how the nervous system can become more sensitive over time, and why pain does not always mean ongoing damage. They also discuss the hormonal changes of menopause, alongside sleep, stress, movement and the many pressures people face at midlife.

A central theme is the importance of being heard. Katy and Barbara talk about why women's pain is sometimes not taken seriously, and how the words used in healthcare can affect how people understand and manage their pain.

Additional links:

1. https://www.imsociety.org/
2. https://themenopausecharity.org/
3. www.livingproof.org.uk
4. http://www.flippinpain.co.uk

In this episode of Heads Up, host Dr Katy Munro, headache specialist at the National Migraine Centre, is joined by Dr Rebecca Walker, a GP with an extended role in headache medicine and menopause care. Together they unpack menstrual migraine and the powerful role of hormones.

They explain how migraine often changes at puberty, during pregnancy and through the menopause transition, and why women are three times more likely than men to experience it. Practical takeaways include how to track headaches alongside your cycle, which contraceptive options are safe with and without aura, and when combined pills, progestogen-only methods or coils may help stabilise hormones. They also review treatment options from anti-inflammatories, triptans and newer gepants to anti-sickness tablets, lifestyle measures, supplements and non-drug neuromodulation devices.

Additional Links:

• Dr David Kernick and Exeter Headache Care: https://exeterheadachecare.co.uk/
• Dr Aziza Sesay and S6 E4: https://www.nationalmigrainecentre.org.uk/understanding-migraine/heads-up-podcast/
• Nerivio: https://www.nerivio.co.uk/
• Cefaly: https://www.cefaly.com/
• Dr Salwa Kamourieh and S2 E10: https://www.nationalmigrainecentre.org.uk/understanding-migraine/heads-up-podcast/
• MyHeadache app:
• Apple AppStore: https://apps.apple.com/gb/app/myheadache/id6746536132
• Google Play: https://play.google.com/store/apps/details?id=com.avegenhealth.hm.dhp302.prod&hl=en_GB
• https://www.headacheaudit.org.uk/migraine-audit
• NICE: https://www.nice.org.uk/
• S5 E4: http://headsup.libsyn.com/exploring-new-anti-cgrp-treatments-for-migraine

Getting the right support for migraine or headache can sometimes feel difficult. How can you prepare for an appointment, make sure your concerns are heard, and get the most out of the time you have with your healthcare professional?

In this episode of Heads Up podcast, our host Dr Katy Munro is joined by Dr Lauren Wellburn and Dr Surangi Mendis, all three headache specialists at the National Migraine Centre, with extensive experience helping people living with migraine and other headache conditions. In this episode they share practical advice on preparing for appointments, keeping a simple headache diary, explaining your symptoms and treatment history, and being clear about what you want from your care.

They also discuss what to do if a treatment isn't working, when it may be helpful to seek a second opinion, and why it's important to understand what happens next.

The episode explores some of the barriers people can face when accessing headache care, including language, health literacy, race, gender, cultural attitudes and wider health inequalities.

Additional information:

1. https://migrainetrust.org/live-with-migraine/healthcare/visiting-your-gp/

2. https://www.nhs.uk/nhs-services/gps/what-to-ask-your-doctor/

3. https://americanmigrainefoundation.org/resource-library/racial-disparities-in-migraine-care

4. https://www.nationalmigrainecentre.org.uk/headache-diary/

In this inspiring episode of Heads Up podcast, our host Dr Katy Munro is joined by Amy Mowbray and Lily Earle, two women who transformed their lives after years of living with chronic migraine and debilitating symptoms. Together, they share their personal recovery journeys and discuss how brain training, pain reprocessing therapy, somatic tracking and self-compassion helped them break free from cycles of fear, sensitisation and disability.

Amy and Lily explain how understanding the brain-body connection changed their relationship with pain, reduced anxiety around migraine attacks and helped them regain confidence, independence and joy. They also offer practical insights into techniques that listeners can explore for themselves.

This conversation is filled with hope, compassion and evidence-informed discussion, reminding anyone living with chronic migraine that recovery is possible.

Disclaimer:

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.

What does it take to kayak the entire British coastline solo while your partner manages chronic migraine from a motorhome on shore? In this first episode of series eight of Heads Up, Dr Katy Munro sits down with Nicola and Dominic Gribbin for an honest and inspiring conversation that covers far more than adventure.

Nicola has lived with migraine since childhood, from episodic attacks during school exams at sixteen, to chronic daily migraine and the added challenge of vestibular migraine. She shares her decades long journey through medications, including the pitfalls of codeine and the life changing arrival of anti CGRP treatment Vyepti, alongside the things that have helped her most: hypnotherapy, coastal meditations, and the unexpected creative outlet of writing her debut fantasy novel. Silent Curse.

Dominic is a TV cameraman and Nicola's husband of over two decades. He reflects on what it really means to be a partner to someone living with chronic pain, talking openly about flexibility, relationship dynamics and choosing to stay positive. Together they are preparing to take on a 2,300-mile kayak circumnavigation of mainland Britain, raising funds for the National Migraine Centre, Parkinson's UK and the Atrial Fibrillation Society.

Follow their journey on Youtube https://www.youtube.com/@EdgeofBritain

Donate here: https://givewheel.com/fundraising/15091/edge-of-britain/

Disclaimer:

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.

Spotlight Series | Heads Up Podcast

What happens when cluster headache and pregnancy collide? In this episode, Daisy joins our host Dr Katy Munro to talk honestly about managing attacks during pregnancy and with a toddler, navigating medication decisions, and the importance of specialist support for anyone planning a family.

For more information visit:

National Migraine Centre: www.nationalmigrainecentre.org.uk

OUCH UK: www.ouchuk.org

https://cks.nice.org.uk/topics/headache-cluster/

Heads Up Episode on Pregnancy and Breastfeeding: https://headsup.libsyn.com/headaches-during-pregnancy-and-breastfeeding

*Disclaimer*

This podcast episode contains discussions about cluster headaches, including topics that may touch upon sensitive subjects such as mental health and suicide. While we strive to provide informative and supportive content, we acknowledge that these discussions may be triggering for some listeners. If you or someone you know is struggling with mental health issues or experiencing thoughts of self-harm or suicide, we urge you to seek support from a qualified healthcare professional or your GP. For emergency call 999 helpline immediately. Your mental health and well-being are important, and help is available.

Listener discretion is advised.

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.

Spotlight Series | Heads Up Podcast

Cluster headache can affect every part of a person's life, including their rights at work. In this episode, our host Dr Katy Munro is joined by Mike Smalley who has had Cluster Headache since the age of 14. Drawing on his experience as a former union representative, Mike discusses what the Equality Act 2010 means for cluster headache patients as this is recognised as a disability and what protections are available. Mike is an admin on a patient support forum.

For more information:

• http://www.facebook.com/groups/clusterheadacheuk
• https://ouchuk.org/reasonable-adjustments
• https://cks.nice.org.uk/topics/headache-cluster/

*Disclaimer*

This podcast episode contains discussions about cluster headaches, including topics that may touch upon sensitive subjects such as mental health and suicide. While we strive to provide informative and supportive content, we acknowledge that these discussions may be triggering for some listeners. If you or someone you know is struggling with mental health issues or experiencing thoughts of self-harm or suicide, we urge you to seek support from a qualified healthcare professional or your GP. For emergency call 999 helpline immediately. Your mental health and well-being are important, and help is available.

Listener discretion is advised.

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.

Spotlight Series | Heads Up Podcast

Isobel West has lived with cluster headache since the age of fifteen. Misdiagnosed for years and left to advocate for herself, she eventually found her way to the correct diagnosis at twenty-one. Now she is channeling that experience into a PhD at Kings College London, investigating the brain mechanisms behind the condition through studying human post-mortem brain tissue donated by individuals who lived with cluster headache and generously donated their brains to research, in collaboration with King's College London. In this episode, she joins our host, Dr Katy Munro, to talk about what it means to be both a patient and a researcher, why diagnosis takes so long, and what her work could one day mean for others living with cluster headaches.

• https://cks.nice.org.uk/topics/headache-cluster/
• https://ouchuk.org/advice-line

*The reference to the study Isobel quoted is here: Frederiksen HH, Lund NL, Barloese MC, Petersen AS, Jensen RH (2020) Diagnostic delay of cluster headache: A cohort study from the Danish Cluster Headache Survey. Cephalalgia 40(1):49–56. 10.1177/0333102419863030.

DD of 18.8 years in age of onset below 20 yrs DD of 5.4 years in age of onset 20-40 yrs DD of 2.1 years after 40 yrs.*

*Disclaimer*

This podcast episode contains discussions about cluster headaches, including topics that may touch upon sensitive subjects such as mental health and suicide. While we strive to provide informative and supportive content, we acknowledge that these discussions may be triggering for some listeners. If you or someone you know is struggling with mental health issues or experiencing thoughts of self-harm or suicide, we urge you to seek support from a qualified healthcare professional or your GP. For emergency call 999 helpline immediately. Your mental health and well-being are important, and help is available.

Listener discretion is advised.

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.

Spotlight Series | Heads Up Podcast

What happens in the brain during a cluster headache attack? In this episode, our host Dr Katy Munro is joined by Dr Phil Holland, a leading headache neuroscientist and previous guest expert on the podcast, to dig into the science behind one of the most extreme pain events the human body can experience. They explore why attacks follow such striking seasonal and daily patterns, the relationship between cluster headache and sleep, the role of brain neuropeptides like CGRP and PACAP, and what emerging therapies targeting these pathways could mean for patients. If you have ever wanted to understand the biology behind the pain, this is the episode for you.

For more information please see the links below:

• https://www.kcl.ac.uk/people/philip-r-holland
• https://www.georgeinstitute.org/news-and-media/news/hope-for-cluster-headache-community-as-psilocybin-trial-funded
• https://cks.nice.org.uk/topics/headache-cluster/

*Disclaimer*

This podcast episode contains discussions about cluster headaches, including topics that may touch upon sensitive subjects such as mental health and suicide. While we strive to provide informative and supportive content, we acknowledge that these discussions may be triggering for some listeners. If you or someone you know is struggling with mental health issues or experiencing thoughts of self-harm or suicide, we urge you to seek support from a qualified healthcare professional or your GP. For emergency call 999 helpline immediately. Your mental health and well-being are important, and help is available. Listener discretion is advised.

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.

Spotlight Series | Heads Up Podcast

Frederick was eleven when diagnosed with cluster headache. Now seventeen and heading to university, they join our host Dr Katy Munro alongside their mum Rachael, OUCH's Officer for Children and Young People, to talk about growing up with one of the most painful conditions known to medicine, sharing tips on how they manage and information about support for families.

For more information visit the links below:

• www.nationalmigrainecentre.org.uk
• https://ouchuk.org/advice-line
• https://cks.nice.org.uk/topics/headache-cluster/

*Disclaimer*

This podcast episode contains discussions about cluster headaches, including topics that may touch upon sensitive subjects such as mental health and suicide. While we strive to provide informative and supportive content, we acknowledge that these discussions may be triggering for some listeners. If you or someone you know is struggling with mental health issues or experiencing thoughts of self-harm or suicide, we urge you to seek support from a qualified healthcare professional or your GP. For emergency call 999 helpline immediately. Your mental health and well-being are important, and help is available.

Listener discretion is advised.

The Heads Up podcast is provided for general information only. It is not intended to amount to medical advice on which you should rely or to advocate or recommend the purchase of any product or to endorse or guarantee the credentials or appropriateness of any health care provider. The National Migraine Centre is not responsible for the views of those featured on this podcast and does not endorse, approve, or certify their recommendations or opinions, and information from this podcast should not be referenced in any way to imply such approval or endorsement. No material within this podcast is intended to be a substitute for medical advice, diagnosis or treatment. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of information provided in this podcast.

Do not begin a new medical regimen, or ignore the advice of a medical professional, as a result of information expressed in this podcast, this website or from any of the sources of information to which we may link. By accessing this podcast, you acknowledge that the National Migraine Centre makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast. Any hyperlinks or references are provided for your convenience & information only. We have no control over third party websites and accept no legal responsibility for any content, material or information contained in them.