Research shows that women are much more frequent victims of migraines than men. But why could this be?
Migraines are a well-established and common condition affecting men, women and children alike. One in seven adults experience migraines globally. However, the distribution of attacks is far from equal. In fact, figures from the Migraine Research Foundation suggest that as many as 85% of all migraine attacks are experienced by women.
Anyone who doesn’t experience migraines would be forgiven for assuming that they are simply intense headaches. However, the reality is much more serious. Alongside a throbbing headache, many sufferers experience nausea, vomiting, dizziness, visual disturbances, light, noise and scent sensitivity and, for some, even temporary muscle weakness on one side of the body. Migraines can last for hours at a time, or even days.
And that’s not all. Around one in four migraine sufferers also experience a collection of sensory disruptions called an ‘aura’, including blind spots, tingling, numbness and light flashes. Research from the American Journal of Medicine also found that migraine auras can increase the risk of ischemic stroke in women under 50.
However, the reason so many women experience migraines compared to men remains largely a mystery.
Director in the Office of Research on Women’s at the National Institutes of Health (NIH), Janine Clayton, comments: “We don’t have the answer for why migraines are more common in women than men, but women are more susceptible to every pain condition than men.
“Also, women in pain are not always taken seriously. Women are perceived as excessively seeking help.”
Migraines tend to be worst for young women, and improve with age, meaning that many women experience regular severe migraines during the period of life when they should be most productive. Symptoms like light and sound sensitivity can make it difficult to work and complete daily activities.
Professor of Neurology & Anaesthesiology and Director of the Centre of Headache and Pain Medicine at Mount Sinai’s Icahn School of Medicine, Mark Green, is just one of many experts who believes that fluctuating female hormones could be a major influence on migraine attacks.
Green theorises that the drop in oestrogen levels which occurs during a women’s period could be a major trigger of migraines, commenting: “Around period and ovulation, and just after a delivery, levels drop precipitously, which can be a problem.
“After menopause, when the levels of oestrogen remain low and don’t fall, most women’s migraines] improve. Oestrogen falls increase the excitability of the brain cortex. Migraine is a condition where the cerebral cortex is more ‘excitable,’ often genetically, so that is one reason why.”
Theories like Green’s are supported by the fact that, in childhood, boys experience more migraines than girls before puberty. From puberty to the menopause, migraines are far more common in women. What’s more, most migraine attacks in women tend to occur several days before or after menstruation.
However, not everyone agrees. Michael Oshinsky, programme director of pain and migraine at the National Institute of Neurological Disorder and Stroke, agrees that hormones may play a pivotal role in migraines, he states that “migraine is not a hormonal disorder. That’s a mistake. Think of it as a very diverse disorder. Each patient has to be diagnosed with her own criteria. There are likely many different pathways not working properly in the brain that lead to an attack. It’s a disorder of the nerves and the brain.”