Women are two to three times more likely than men to have migraines. The condition typically hits women hardest in their thirties, when the consequences of days lost to debilitating pain can be tremendous. For more than half of women aged between 18 and 60, the onset and timing of migraines is connected with the hormonal flux of their menstrual cycle.
And yet little research has been done to explore the nature of sex-related differences in migraine or their clinical consequences. Much of this knowledge gap is attributable to gender bias — a pervasive problem in clinical research.
Young boys and girls are about equally likely to develop migraine. But at puberty, the prevalence in females rapidly escalates. Through adulthood, migraine risk increases in everyone, but it continues to climb more steeply in women.
Their risk peaks at around age 35, then gradually tapers off until it declines steeply at menopause. In all, the prevalence of migraine in women is estimated to be around twice that of men.
Part of Nature Outlook: Headache. In , clinician Brian Somerville, then at Prince Henry Hospital in Sydney, Australia, published the first study tying shifts in female sex hormones to migraine headaches 1. It has since become clear that the rise and fall of oestrogen is a particularly important driver in this process. She says that such rises and falls become especially dramatic during the perimenopause — the period before the complete onset of menopause — when oestrogen levels fluctuate wildly.
This causes irregular menstrual cycles and the onset of more frequent and erratic migraine episodes. It can last for several years, or even a decade. This interplay can complicate hormonal treatments. For example, oral contraceptive prescriptions typically include a seven-day span of in which pills should not be taken or placebo pills are provided instead, setting the stage for a migraine-inducing period of oestrogen withdrawal.
MacGregor also notes that some people who receive hormone replacement therapy to mitigate symptoms associated with the onset of menopause risk aggravating their migraines. Oestrogen administration also seems to boost the rate of migraine in transgender women. Oestrogen alone does not fully explain sex differences in migraine. Last year, neuroscientist Greg Dussor at the University of Texas at Dallas discovered striking differences in how male and female rats respond to a signalling molecule called calcitonin gene-related peptide CGRP 3.
Hormone levels fluctuate for a number of reasons. However, the most dramatic hormone fluctuations occur:. Hormones play a significant role in headaches, but they are not the only cause. Migraines, cluster headaches and tension headaches can occur from heightened stress or emotional distress. Other causes include:. Maintain a healthy lifestyle that includes nutritious foods, adequate hydration, frequent exercise and proper sleep.
Ask your physician about daily vitamins or supplements, such as vitamin B or magnesium. If you find yourself experiencing a headache, seek a quiet, dark place to rest. Use a damp cloth on your forehead to provide additional relief. Gently rub the area with your forefingers. If headaches persist, keep a journal to better identify triggers to discuss with your physician.
If you suffer from headaches, treatment options will depend on the severity of the headache and your overall health. Fortunately, there are a number of options available if lifestyle changes do not provide adequate relief.
These block the effect of CGRP, a small protein found in the sensory nerves that supply to the head and neck, and can prevent headaches from occurring. Some headaches, such as those resulting from a concussion , may require specialized care during recovery. Your healthcare provider will help you determine what treatment is right for you. Many women find their migraine symptoms are affected by menstruation, hormonal contraception, pregnancy, and menopause.
The information provided here should not be used for the diagnosis, treatment, or evaluation of any medical condition. The Migraine Research Foundation has made every effort to ensure that the information is accurate; however, we cannot warranty its reliability, completeness, or timeliness. Your gift provides hope, help and healing to the millions of migraine sufferers and their families.
You will receive a credit card receipt via email. Talk with your doctor about what sets off your headaches to help find the right treatment for you. Yes, there are many forms of migraine. The two forms seen most often are migraine with aura and migraine without aura. Migraine with aura previously called classical migraine. With a migraine with aura, a person might have these sensory symptoms the so-called "aura" 10 to 30 minutes before an attack:. Only one in five people who get migraine experience an aura.
Women have this form of migraine less often than men. Migraine without aura previously called common migraine. With this form of migraine, a person does not have an aura but has all the other features of an attack. Compared with migraine, tension-type headache is generally less severe and rarely disabling. Compare your symptoms with those in this chart to see what type of headache you might be having.
Adapted from a table produced by the American Council for Headache Education. Although fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by certain foods, changes in the body's hormone levels, and even changes in the weather. There also are differences in how types of headaches respond to treatment with medicines. Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.
You can't tell the difference between a migraine and a tension-type headache by how often they occur. Both can occur at irregular intervals. Also, in rare cases, both can occur daily or almost daily. Many people confuse a sinus headache with a migraine because pain and pressure in the sinuses, nasal congestion, and watery eyes often occur with migraine.
To find out if your headache is sinus or migraine, ask yourself these questions:. A true sinus headache is rare and usually occurs due to sinus infection. In a sinus infection, you would also likely have a fever and thick nasal secretions that are yellow, green, or blood-tinged. A sinus headache should go away with treatment of the sinus infection. Sometimes, headache can signal a more serious problem. You should talk to your doctor about your headaches if:.
If you think you get migraine headaches, talk with your doctor. Before your appointment, write down:. Your doctor may also do an exam and ask more questions about your health history. This could include past head injury and sinus or dental problems. Your doctor may be able to diagnose migraine just from the information you provide. You may get a blood test or other tests, such as CT scan or MRI, if your doctor thinks that something else is causing your headaches.
Work with your doctor to decide on the best tests for you. Migraines are most common in women between the ages of 20 and At this time of life women often have more job, family, and social duties. Women tend to report more painful and longer lasting headaches and more symptoms, such as nausea and vomiting. All these factors make it hard for a woman to fulfill her roles at work and at home when migraine strikes.
More than half of migraines in women occur right before, during, or after a woman has her period. This often is called "menstrual migraine. Most have migraine headaches at other times of the month as well.
How the menstrual cycle and migraine are linked is still unclear. We know that just before the cycle begins, levels of the female hormones, estrogen and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals in the brain that affect a woman's pain sensation.
Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.
If your migraine headaches are closely linked to your menstrual cycle, menopause may make them less severe. As you get older, the nausea and vomiting may decrease as well. About two-thirds of women with migraines report that their symptoms improve with menopause. But for some women, menopause worsens migraine or triggers them to start.
It is not clear why this happens. Menopausal hormone therapy , which is prescribed for some women during menopause, may be linked to migraines during this time. In general, though, the worsening of migraine symptoms goes away once menopause is complete. In some women, birth control pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe.
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