A migraine is more than a bad headache; it’s a neurological disorder that saps a person’s energy. During an attack, people with migraines often experience extreme sensitivity to light and sound, plus nausea and vomiting.
Migraine: A Predominantly Female Issue
A migraine attack can last for several hours or even days. To ease the pain, people with migraines often retreat to a quiet, dark room.
Globally, around 800 million people suffer from this condition, and the majority are women. Women are about three times more likely than men to have migraine attacks, and their attacks tend to last longer.
Many women even lose the ability to work because of these persistent headaches. They often rely on medication and may develop depression as a result.
The Hormonal Influence on Migraines
Several factors shape how migraines differ between the sexes. Hormones and genetics are two of the main drivers. They influence brain function and its response to migraine triggers. Estrogen and progesterone can alter brain regions involved in migraine development.
Children, regardless of gender, have an equal chance of developing migraines, which occur in nearly 10% of them. With the onset of puberty, the likelihood of migraines in girls rises because of fluctuations in sex hormone levels. Many girls experience their first migraine around their first period. The condition is even more common and intense among women of reproductive age.
Nearly 50–60% of women experience migraine attacks during menstruation or in the days before it begins. This may be linked to a drop in estrogen levels. Menstrual migraines can be more severe and longer-lasting than other attacks.
To treat migraine attacks, triptans—medications introduced in the 1990s—are commonly used. Nonsteroidal anti-inflammatory drugs (NSAIDs) also help reduce pain and the duration of menstrual migraines. Keeping hormone levels stable may also help manage migraines.
Migraine with Aura: Similar to a Stroke
In cases of migraine with aura, where people experience visual, taste, or tactile disturbances, standard approaches may be less effective. People with migraine with aura are generally advised to avoid estrogen-containing hormonal contraceptives because of an increased risk of stroke. For contraception, progesterone-only pills and intrauterine devices are safer options.
This type of migraine affects about 20% of people with migraines. Often dark spots appear before an attack, and in about 10% of cases people lose the ability to speak clearly and experience tingling on one side of the body.
These symptoms build up and last for a period of time. Like a typical migraine, the attack is followed by a severe headache. The initial symptoms may resemble the onset of a stroke, but unlike a stroke they develop gradually rather than suddenly. For anyone without medical training, distinguishing between the two can be difficult, so it’s best to seek emergency help.
Migraine During Pregnancy and Menopause
Migraines are often most debilitating during pregnancy, especially in the first trimester, when morning sickness can make eating and sleeping difficult. Lack of sleep or food can increase the likelihood of an attack.
However, during pregnancy migraines tend to decrease in frequency and severity, and in some women they disappear entirely. If a woman experiences migraines during pregnancy, they usually intensify after childbirth. Hormonal changes, stress, lack of sleep, dehydration, and the demands of caring for a newborn can all play a role.
Migraine attacks may worsen during menopause because of hormonal fluctuations, depression, and sleep disturbances. As menopause progresses, migraines often decrease and may even vanish. Hormone replacement therapy can help reduce the frequency and severity of attacks at the onset of menopause.
Male Migraines
Severe migraine attacks are most commonly reported by men in their 20s. As men age, attacks tend to slow down, peak again around age 50, and then decrease or stop altogether.
Doctors don’t fully understand this pattern of migraines in men. A mix of environmental and lifestyle factors, together with genetic influences, may contribute to the changes in frequency.
