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Serena Williams was 18 when she was stricken with the first of several excruciating headaches. But she didn't learn that she was suffering from menstrual migraines until five years later, when a sudden and severe headache cost the tennis star a match and prompted an early elimination from a tournament for the first time in her professional career. According to the National Headache Foundation, an estimated 13 million American women are affected by this type of migraine, but most of them don't realize it.
Williams, now 23, says she thought the timing of the headaches was coincidental. But menstrual-related migraines, which affect approximately 60 percent of female migraine sufferers, are specifically triggered by the drop in estrogen levels just before or during the period of bleeding. "Basically, it's an estrogen-withdrawal headache," says neurologist Dr. Joel Saper, founder of the Michigan Head Pain & Neurological Institute.
While menstrual migraines can be particularly painful, they are also somewhat easier to treat because patients can use migraine medicines more aggressively than if they had to take them all the time. Williams has signed on as spokesperson of the new National Menstrual Migraine Coalition, formed by the National Headache Foundation with funding by Endo Pharmaceuticals, which manufactures Frova, the migraine medication Williams has been taking with good results since last fall. The group recently launched the "Rally for Menstrual Migraine" campaign in an effort to help women recognize the symptoms and encourage them to talk to their physicians about available treatments for menstrual migraines. Frovatriptan, or Frova, is one of several drugs that can be taken at the onset of a migraine to stop the attack. There are also preventive prescription treatments. Over-the-counter analgesics like aspirin, acetaminophen and ibuprofen--and even alternative remedies--may also be effective.
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Williams, who has been busy preparing for the French Open and promoting a new reality show and new book with her big sister, Venus, took time out to speak with NEWSWEEK's Jennifer Barrett about the campaign. Excerpts:
NEWSWEEK: Had you heard about menstrual migraines before you were diagnosed?
Serena Williams: I'd never heard of them before. All this time, I thought it was a regular migraine.
How bad were your migraines?
They were really splitting headaches. Mine went from the left to the right side of my head, and it was pretty intense. It's a pretty uncomfortable feeling, obviously.
I understand that a menstrual migraine cost you a match in the first round of an Austrian tournament last year. What happened?
I was playing when I got [the migraine], and I couldn't focus. I was so dizzy and nauseated, and I was really tired. It was frustrating because I had never lost a first round.
Did you change your treatment after you realized you had menstrual migraines?
I happened to be talking to a friend last fall who was a doctor, and he told me about Frova. I didn't think it would work because I'd tried a lot of medications. But it works really fast for me. I haven't had a migraine since. Of course, there are a lot of treatments out there, and they might work for others.
Do you think there are misconceptions about migraines?
I definitely do. I was misdiagnosed for four to five years. I just recently found something that works for me.
Besides medications, are there other changes you've made to help fight your migraines?
I try to stay inside when I get them because the light bothers me. But obviously it's hard during matches.
Have you noticed other things that can trigger the migraine or make it worse?
Actually salt seems to be a trigger. So I have to avoid soy sauce and things like that. That's hard because I crave salt.
Did you try other medications, too?
I was trying over-the-counter and prescription drugs, a little of both. But they didn't work for me.
You've got a new reality show premiering on the ABC Family network in July with Venus. What are viewers going to see?
It's going to be about who we are, and the camera will follow us in our lives. You'll meet other characters in our lives, too, like my dad and my mom and my other sister.
How did the show come about?
My sister [Venus] and I were watching reality shows and realized they weren't at all reality. We wanted to give people a chance to see what reality really is. We were looking to do something different.
What do you hope viewers will get out of it?
I think people can relate to us on a lot of different levels. They will see some things we do and think, "I do that too." It's more realistic. I hope they get positiveness out of it. We try to do the best we can. We work hard. We own different businesses [Serena has a fashion line and Venus owns an interior-design firm], and we play professional tennis. It can be done. You just have to put your mind to it.
You've also just written a book together, "Serving From the Hip: 10 Rules for Living, Loving and Winning."
We have 10 different chapters and we talk about different things like loving the skin you're in: loving yourself and whatever type of person you are. You have to love you. We also have a chapter, "All About the Money, Honey," that's about learning to use your money wisely. These are rules that teens, preteens and early adults can use. We wanted to write the book because we thought it would be nice for people to see a different side of us and to have positive role models.
And then there's tennis. I know you pulled out of the German Open because of an ankle injury. How's your ankle now?
It's actually much better. And now I am working to get in shape.
Will you compete in the French Open?
Yeah. I am about to start warming up for that now.
With everything you're involved in, how do you find the time to speak out about menstrual migraines, too?
Honestly, I don't know. [Laughs.] I'm just taking it one day at a time and going from there. It is an important topic. People shouldn't have to deal with migraines. It's one of the worst things. And the thing is, you don't have to deal with them. There are treatments out there.
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