For She Speaks, Luüna founder Olivia Cotes-James shares her personal journey in diagnosing menstrual migraines and how dismantling the stigma surrounding menstrual health can help bridge the gender pain gap at the workplace
Over the past few years, I’ve increasingly struggled with migraines. If you have migraines, you know—they can derail every aspect of life, from work to social plans, and weigh heavily on your mental and physical health.
Despite founding Luüna, a social enterprise dedicated to advancing menstrual equity, it still took me far too long to connect these migraines to my cycle. It wasn’t until I started consistently tracking my symptoms using a cycle app that I noticed the pattern: like clockwork, these migraines hit just before my period. How had I, someone immersed in menstrual health every day, missed this connection for so long?
Through research, I realised I was not alone in this experience. McKinsey identified migraines as one of four key factors affecting the health span of women and contributing to the gender health gap—a gap which sees women spending an average of nine years of their lives in poor health, which is 25 per cent longer than men. While migraines affect both men and women, they are often linked to hormonal changes and women report longer attack durations, increased risk of recurrence, greater disability and longer recovery times.
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Olivia Cotes-James (Photo: Tatler Hong Kong)
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In fact, McKinsey revealed that women are 3.25 times more likely than men to experience migraines. Yet research into women-specific migraine experiences remains severely lacking. This is the gender health gap in action: a systemic inequality that leaves women’s pain under-researched, undertreated and often ignored.
The gender health gap doesn’t just impact individuals—it shapes entire systems. When women’s pain is dismissed or overlooked, it limits their ability to participate fully in society—from education to career progression to family life.
We explored this at our recent event in Hong Kong, Unpacking the myths and realities of the gender pain gap. The discussion highlighted how stigma around women’s health has negative implications across multiple levels:
- Individuals believe their pain is ‘normal’ and something to simply push through
- Healthcare systems, where even doctors may dismiss menstrual-related pain as “just bad periods” rather than exploring them as symptoms of underlying health conditions
- Corporate cultures, where women may fear being judged, dismissed or penalised if they mention menstrual-related health challenges.
At the event, we also acknowledged that health disparities extend beyond gender alone—factors such as race, sexuality and socioeconomic status can further deepen these gaps. While men also face inequalities in healthcare, one striking example of the disadvantages women continue to face is that it wasn’t until the 1990s that the FDA permitted women’s bodies to be included in late-stage clinical trials. As a result, much of what we know about pain recognition and treatment is based on studies conducted on men, meaning many treatments still fail to address the unique needs of women’s bodies.
