Migraine impacts nearly 13% of the population globally. While both men and women suffer from migraines, women are three times more likely than men to develop the condition: it occurs in 6% of men and 18% of women. Women are also at greater risk of prolonged attacks and more severe symptoms.
The most significant differences between male and female migraine sufferers are the frequency, duration, and disabling nature of attacks. Women tend to experience more frequent, longer, and more disabling attacks than men. Women with migraines also have more comorbidities, especially mental comorbidities, like anxiety and depression, than men with migraines. Additionally, women often experience menstrual-related migraines, which can be more disabling than non-menstrual attacks.
Researchers believe that the connection between migraines and menstrual cycles is related to the hormone estrogen. Women whose estrogen levels drop steeply before menstruation have an increased likelihood of developing migraine. The degree of fluctuation, rather than the amount, is thought to be the main indicator. Many women experience a period of relief from migraine attacks during pregnancy due to the elevated level of estrogen, but the drop in estrogen after pregnancy can trigger attacks to start again. The uneven rise and fall of estrogen levels during perimenopause, the period just before menopause, can also increase headache frequency and severity. Many women see an improvement once they reach menopause.
For women with predictable menstrual-related migraines, taking daily triptans or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, a few days prior to and throughout menstruation may help mitigate migraine symptoms. Continuous hormonal contraception may also be used to prevent menstrual-related migraines by preventing the drop in estrogen, though this method can make migraines worse for some women.
While the exact mechanisms of migraine are still being studied, hormonal fluctuations seem to play a significant role. Understanding the way migraines affect women differently than men is critical to developing effective treatments and providing adequate support for sufferers. The Will Erwin Headache Research Foundation is dedicated to supporting sufferers globally and finding a cure for all debilitating headaches. If you want to contribute to our efforts, consider donating today.