International Women’s Day 2023: #EmbraceEquity
To mark International Women’s Day (8 March 2023), Dr Rebecca Walker, a senior headache specialist at the National Migraine Centre, spoke to her colleague and mentor Dr Katy Munro about women, medicine and migraine.
Dr Katy Munro
Today (8 March 2023) is International Women’s Day, a global celebration of the social, economic, cultural and political achievements of women. Katy Munro is a senior doctor at the National Migraine Centre and an expert in migraine and headache medicine.
Katy is also the author of the bestselling book Managing your Migraine, which has been translated into many languages, and is an invaluable resource for patients and practitioners around the world who want to learn more about this impactful and often misunderstood condition.
Thank you for taking the time to answer a few questions. Katy. I wonder if you could start by telling us how you came to be a headache specialist, and a respected author and authority on migraine?
I initially became interested in headaches and migraine after starting to have attacks in my early forties. Even though I was a GP, it took me a while to find a way forward in gaining an understanding of my diagnosis and a good management plan.
The National Migraine Centre doctor who saw me as a patient then was so kind and helpful. I went to a couple of study days the charity ran for GPs to learn more and was inspired by the holistic approach and the ethos. Later, I was fortunate to be able join the charity as a GP headache specialist and my interest and involvement grew from there.
With several colleagues, we started the Heads Up podcast as a way of sharing good, evidence-based information with anyone interested in migraine and other headache – we were in the top three finalists for Podcast of the Year in 2021 and only lost out to the BBC.
Over time, I began to be the main media contact for statements from the National Migraine Centre to radio and TV journalists and I wrote several articles for print publications.
I was also approached by Penguin Random House in 2020 to write a book about migraine for their Penguin Life Expert Series and I jumped at the chance. My book was published in 2021.
Who has inspired you in your career?
In my career as a GP, other women GPs have often been a source of inspiration as they so often combine multiple roles and interests to a high level as well as managing much of the day-to-day running of a home.
As a headache specialist, top of my list would be Professor Anne MacGregor, who has worked for decades to improve the understanding of migraine and hormones in women and who is also a kind supporter of the National Migraine Centre and an inspirational teacher.
‘Luckily, my husband and I have always been a good team and my kids have become great cooks!’
Over the course of your career have you faced any barriers due to being a woman?
Not that I am aware of specifically, apart from the challenges of balancing a busy career as a GP with the roles of wife, and mother to my three children. I have always worked in a supportive team and was lucky to be in a GP partnership for many years with a very good team working experience, no matter what your gender.
My choice was to be a ‘part-time GP’ to allow myself to work but also see my children and husband. I say ‘part-time’ because even when I left NHS general practice in 2013, part-time was a misnomer. I often worked a 40-hour week and had the responsibility for many of the aspects of running a practice. Luckily, my husband and I have always been a good team and my kids have become great cooks!
What are you most proud of?
In my headache specialist role, I am so proud of the Heads Up podcast and the team that helped launch it. We have reached nearly 200,000 downloads on a virtually zero budget and with the passion to share helpful information being the driving force behind it.
As an NHS GP, I am very proud of the Potters Bar Bereavement Service, a voluntary visitor organisation to support the bereaved, which I help set up and of which I was chairperson for 12 years.
What is the most important piece of advice you can share with women entering a career in medicine?
Every woman is so different and their career aspirations and hopes for the future so varied. I think the best piece of advice I can give is to learn to communicate well. Listening is an invaluable skill, explaining and teaching skills are so helpful and at times, speaking out assertively is essential. Most problems can be greatly helped by great communication and a large dose of kindness.
Are there any differences in migraine between women and men and are there differences in how you treat the condition?
Although the genetic, neurological condition of migraine is much the same in any gender, many more women than men experience migraine largely due to hormonal influences. Transitioning to female may also trigger or worsen migraine.
The treatments we use are often similar but the role of hormones, especially oestrogen, mean that the conversations with girls, women and transwomen will often require a clear knowledge of their hormonal status, menstrual history and perimenopausal symptoms. Treatment options for women and transwomen, may include trying to control oestrogen fluctuations.
Historically, women have struggled to be treated respectfully, effectively and swiftly enough due to the stigmatisation of migraine and women’s pain. This still needs to improve.
Do you have any advice for women who experience migraine and who may be struggling in the workplace or feel stigmatised because of migraine?
The best way to explain your needs as a person with migraine is to arm yourself with information about the condition, the way if affects you and what can be reasonably done to help and support you in the workplace or even among family and friends.
The impact of migraine ripples out and if you are surrounded by people who, mistakenly, equate migraine with being ‘just a bad headache’, then you may need to point them towards good sources of information to help them get a better understanding. We all need to be Migraine Advocates! My book has a chapter on migraine at work and we have an episode of the podcast on this topic.
‘We need to keep fighting for migraine to be taken seriously as a neurological, disabling condition…’
What can we do to help raise awareness of migraine?
Keep talking about it!
Migraine affects 15 per cent of the population, one in five women, but still I hear both patients and healthcare professionals say, ‘Oh, I didn’t know that…’ about so many aspects of migraine care.
Keep learning about it too. There are so many exciting developments in the treatment of migraine coming along.
We need to keep fighting for migraine to be taken seriously as a neurological, disabling condition and not one that is dismissed as, ‘Oh, it’s probably just stress” or worse, ‘You’ll find it gets better after the menopause’. These kind of comments are not good enough when women are losing their jobs or migraine is having an impact on their careers, family and social life.
What does ‘Embrace Equity’ mean to you?
In the world of general practice and in migraine care, giving the right individualised help to each person I am seeing is all about equity. It’s about tailoring the options to work best for each person’s circumstances. People need to be empowered to make their own choices and have a wide range of options to choose from.
Lastly, a lighter question! If you could have dinner with three inspirational women, dead or alive, who would they be and why?
Ooh, I love this question! I would love to dine with Michelle Obama, who I think is an incredible inspiration.
Professor Anne MacGregor is a major reason why I am where I am due to her inspirational talks at the study days I went on originally and her subsequent help and support for our charity.
Finally, the most inspirational women may often be the ones quietly getting on with the hurly-burly of daily life, taking in their stride all the trials and tribulations, enriching other people’s lives in so many ways but doing it gently, with no trumpets or fanfares. One of the greatest of these is my sister, Jess Bleackley. She would definitely need to be at my table.
Thank you so much, Katy, for your time and such an honest and inspirational interview.
Find out more about Katy, Rebecca and the National Migraine Centre team of headache specialists here.