Eighty-six percent of our audience says they experience migraines. Hey, fam.
I’ve had regular migraines since I was 12. Mine, which are triggered by barometric pressure changes, thankfully follow a pattern and aren’t as recurrent as some of my friends’ headaches. They begin with pain-free vision loss—an ocular migraine—which is my signal to find medication and caffeine ASAP. In that window, I down two extra-strength acetaminophen and whatever is left of my coffee. Then I self-soothe. The less I anticipate pain, the better the outcome.
This system is imperfect, but mostly effective. Still, during the ocular migraine, which lasts for about 30 minutes and fades as the full-fledged migraine kicks in, I can’t work because I can’t see. And even if I do manage to stop most of the pain before it starts, my body is still working hard, and it shows. My brain is fuzzy, I’m low energy, and well into the next day I have a “hangover” that slows my communication and movement.
Do I power through sometimes? Absolutely. Even though my team is the best and fully supportive of me taking sick time to recover. I don’t like to miss work—not for something that I can handle.
And that reasoning is the gender pain gap in action.
The gender pain gap refers to the disparity between how men’s and women’s pain is perceived, experienced, and treated. If you’re a woman who experiences chronic pain (fibromyalgia, endometriosis, migraine, etc.), it’s likely you’ve had at least one doctor, manager, friend, or family member downplay your experience. Maybe they diagnosed it as stress or anxiety. Maybe, when you called out for the day, your manager responded, “Well you sound pretty good” instead of offering care.
Over time, those micro-dismissals add up. It becomes easier to be quiet, polite, and productive rather than to explain to the umpteenth person why you need to dim the lights in your office. Easier to push through than to justify your experience.
But there’s a cost: your body, your comfort, your wellbeing. Even the quality of your work.
Here’s how one of our survey respondents framed the benefits of self-advocacy amid migraine strikes:
“Nobody wants shoddy work, and that's what you'll get if you expect a suffering person to perform. Having understanding management that allows flexibility is key—lean on coworkers for assistance, offer them the same. Check out when you need it. Your health is the most important thing no matter what. There'll be a later time when you're functional and well to make up for time lost.”
I agree, wholeheartedly. But in practice, it’s still hard to step away—and for many people, it’s impossible. Not everyone can safely advocate for themselves or take sick time without risking their job or livelihood. The gender pain gap intersects with job insecurity, disability stigma, and workplace inflexibility, making pain management even harder for many.
On my end, I’ve been trying to unlearn the lessons of the gender pain gap for years. Now I put a little “sick” emoji in my Slack status. I cancel meetings. Occasionally, I fully log off.
I still feel guilty. But I think that emotion will be the last symptom to go.
What matters most is that I see the value in prioritizing my health, and I’m willing to take the uncomfortable step to protect something I’ve decided is sacred.
How do others handle migraines at work? Here are a few reader responses that stood out:
“My first day on the job as a 17-year-old cashier at an office supply store, I just worked through it, vomited, and went back to work because I didn't want to go home early on my first day. Now as a 53 year old I would take some medicine, go home, and take a nap to sleep it off.”
“I have asked for the fluorescent lights to be disabled over my cubicle as I work in an open office where I can’t turn my lights off. I have warm lamps on my desk instead. Cubicle walls are high so this bothers no one. I argue this is preventive and I never have to take time off for migraines because my preventive efforts are effective!”
“For people who don't get migraines they don't realize how different they are from a headache, so it's been helpful to actually describe what's going to happen if I don't get home and into a cool dark space where I can curl up in bed and pray for either sleep or death (joking). Like, telling them there's a point where I wouldn't be able to drive home because of it, helps explain the gravity of how severe migraines can be. And I have slept in my car before driving home before. They are debilitating.”
“I don't—I am self-employed. Previously, unsuccessfully. I am a woman in a traditionally male profession, any show of weakness would have set me back. I dealt with them and every other illness by hiding them and continuing on.”
“Thankfully, I have a boss who understands migraines. If I tell her I feel one coming, she knows I have a short period of time in which I am still safe to drive and I need to get home. Being open and honest about my symptoms when they first started happening at work really helped.”
“If chronic, get with your HR department you may need intermittent FMLA.”
“I typically request 1:1 meetings and bow out of group meetings. I will turn off my camera for all virtual meetings. I focus more on solo work.”
“I go to a private ‘huddle room’ and turn the lights off. I let my boss know where I am just in case I am needed.”
“It's important that I prioritize my health so if I get a migraine on a workday, I enlist backup and log off. It's easier at my company because even my CEO gets them.”
“I have asked HR for accommodations so I’m able to work from home more often if I’m experiencing a migraine.”
“Previously, my migraines would leave me debilitated; unable to see, sometimes throwing up. It was clear that there was a medical issue. Companies / managers I've worked for have been mostly understanding, with one or two being the exception rather than the rule. Mine generally last for one day with there sometimes being a ‘hangover’ the next day. I speak to my manager, let them know it's an issue and given I generally work hard around that, it hasn't been too much of an issue.”
