My Experience with Botox for Migraines
Last updated: May 2023
In November of 2021, I was four months out from delivering twins too prematurely to survive, I was back in fertility treatments, I was parenting a then 2.5 year old, and I was in and out of the emergency room for migraines regularly. It was awful.
What did my migraine specialist recommend?
I began to see a migraine specialist, a neurologist working at a headache clinic, and he suggested Botox for migraines.
As a father himself, he knew how important it was for me to continue trying to grow my family, and how few preventative migraine treatment options were available that were also safe for pregnancy.
[Note: I know and fully understand that not every doctor, OB, MFM, midwife, or provider recommends receiving Botox during pregnancy. I did extensive research of my own, and ask that you do the same before making any decision on any form of treatment you pursue whether or not you're pregnant, trying to get pregnant, or just chilling. Also note: I have not been pregnant since beginning to receive Botox injections.]
How often are my Botox injections?
The current recommendation is to receive Botox for migraine prevention approximately every 12 weeks.1 My insurance requires 84 days between treatment, so I usually stick right around that time schedule. I've had 5 rounds of treatment since November of 2021, with my next appointment right around the corner for round 6.
Am I getting the recommended dose?
The recommended dose of Botox for migraine prevention is 155 units administered intramuscularly into 5 unit injections (31 total) across 7 specific head and neck muscle areas including the forehead, the top of the nose, around your temples, the back of your head, your neck, and your shoulder blades.2
Do the injections scare me?
As someone who has gone through close to 1000 injections for IVF and have done many of them on my own, the injection part didn't scare or concern me. The needles are quite small. The difference though, is that getting injections into your face, neck and shoulders doesn't have much fat or padding, and definitely feel more prickly and a bit more painful than injections that go into your stomach or thighs or even upper arms. The procedure is quick - it's usually about 10-15 minutes of injections total, and I always combine it with a follow up appointment from the last few months including an update for my doctor and any questions I have or challenges I've faced since we last met.
How did my first round of treatment go?
Now, about a week after the first round of treatment I had, I said to my husband "I swear my eyebrows have changed shape" - and he reminded me that I did, in fact, have Botox the week prior. At my next treatment and every one since, I've reminded my doctor do those specific injections a bit higher up so that they don't change my eyebrow positioning or the way my face looks. [Note: If in fact thats a thing you'd appreciate/enjoy/a hidden bonus of the treatment, take full advantage of the opportunity!]
How has it been going?
In truth, I was skeptical that the treatment was doing anything until this past November, when I got my 5th treatment, and was able to notice that I hadn't been to urgent care or the emergency room or even the infusion center for abortive IV migraine treatment since beginning Botox. In transparency, I also take Qulipta, a preventative migraine medication orally, so it's possible that's impacted the migraine relief I've received, but either way, I'll take it. If there's any chance that the Botox is helping, I'll continue to get it, even though it's uncomfortable and can be annoying to remember to schedule - it's far better than the alternative.
Does Botox help my TMJ?
One additional piece of information for those who might be looking for additional suggestions - many of my migraines start from grinding my teeth or clenching my jaw for hours (days) on end. My neurologist now does a few additional injections into my jawline which supposedly help reduce that too. We've only tried it twice, so if over time I find a major difference I'll come back to write more.
Have you gotten botox for migraine prevention? I'd love to hear your experiences below.
Are the family and friends you will be seeing this holiday season understanding about migraine?