Migraine in Men – Does it differ?

Migraine has previously been ranked in the Top 7 as one of the most debilitating illnesses in the world, and the leading cause of disability among neurological disorders. Unless you’ve gone through a migraine attack first-hand, it is easy to have misunderstandings about this invisible illness that few really take the time to know about.

One of the most common myths is that migraine only affects women. It is well known that migraine disproportionately affects different genders and a large majority of the community who suffers from migraine are made up of women. However, migraine in men is still as prevalent but rarely talked about. 

According to the Migraine Research Foundation, women are three times more likely to suffer from migraine than men, and Mayo Clinic affirms that 17% of women are migraine sufferers as opposed to 6% of men. This survey shows there are differences in how men experience migraine, that men suffer from longer headaches and report lower symptom scores than women. 

Based on data reported by Migraine Buddy users, 65% more males record that they have no symptoms. With regards to women on the other hand,  25% more have recorded anxiety and also insomnia as a symptom. However, the results also display a 43% increased risk of progression from episodic to chronic condition in men.

Today, some consider chronic migraine (>15 migraine days per month) as an individual and societal burden as it is more disabling than episodic migraine. A hypothesis to this higher probability of progression could be that men are often not diagnosed or misdiagnosed. This study shows that men are more likely to use non-prescription drugs as compared to women, which when taken more than twice a week can lead to medication overuse headache. With reference to Migraine Buddy users, data shows that men are 6% more likely to report their medication intakes. 

This difference between the male users of Migraine Buddy and the majority of male migraine sufferers can be explained by the degree of involvement these users already have achieved in the consideration of their migraine. They are representative of men who have consulted a doctor and track their migraine on a regular basis. A literature review displayed that men utilize health resources less often than women. 40% of male migraine sufferers interviewed during another study reported seeking medical assistance when experiencing headache against 80% when experiencing backache.

Why is that? Socio-cultural reasons play a critical part. In some cultures it is harder for men to endorse the sick role as they are expected to be the provider at home and the strong at work. Men are therefore more inclined to neglect their pain or rely on over-the-counter (OTC) medication. 

The medical system’s perception of migraine also plays a crucial factor. Dr. Lipton, the Edwin S. Lowe Professor and Vice -Chair of neurology at Albert Einstein College of Medicine and director of the Montefiore Headache Center talks about migraine as being perceived as a women’s disease. 

According to one of his studies, male gender is a common barrier to correct diagnosis of migraine. He mentioned that “the notion that migraine is a women’s disease simultaneously stigmatizes the disorder and denies men access to care.” 

In men and women, various triggers have been identified to generate migraine attacks. Though stress, lack of sleep and weather changes are common migraine triggers, Migraine Buddy data shows that men are 40% more likely than women to experience migraine due to physical exertion. This tendency is confirmed by larger scale studies. Physical exertion can refer to both low and high intensity movement, from climbing the stairs to running a half-marathon. 

Scientists at Harvard Medical School started exploring relations between this trigger and high blood pressure related issues. This article shows that migraine sufferers are 50% more likely to have heart attacks as non-migraine sufferers. It remains unclear how migraine attacks are related to higher cardiovascular risks, however the theory is that they share common mechanisms. It is always recommended  to consult your doctor if you are unsure to prevent further complications.

Hormonal imbalance is a prevalent  trigger among women with migraine. Research has proved that changes in oestrogen levels have direct relation with the frequency or intensity of migraine attacks. A few years ago, scientists started looking at the influence of female hormones in men with migraine. This study reports that men with migraine displayed an increased level of estradiol (type of oestrogen hormone) and clinical evidence of androgen deficiency (less male hormones). If the oestrogen/testosterone ratio is implied still remains to be explored in further research. Hormonal medication could become a way to reduce migraine in men but no scientific evidence had been raised so far to support this treatment.

Even though migraine is popularly associated to a strong headache, many studies show that it can lead to intense suffering, decrease in quality of life and affect the ability to perform well in both personal and professional life. Sufferers report that migraine has a negative impact on their ability to succeed in their studies or in their finances. An increased risk of frequent or chronic headache is associated with low individual income. The Migraine Buddy Team has also discovered that male users were more likely to report depression as a symptom for their migraine. The link between migraine and depression has been established for a long time. Due to their condition, migraine sufferers, especially chronic migraineurs might have a lower quality of life. Furthermore, men could be more exposed to depression considering their incapacity to undertake the role of provider when enduring attacks. The feeling of being helpless and and unreliable in societies where it is expected from men to perform is a considerable factor which may induce the onset of depression.

Migraine is often misunderstood as a regular or slightly stronger headache. However, migraine is a serious neurological condition which affects 1 billion people globally. The World Health Organisation considers migraine to be in the top 20 of most disabling illness but unlike other diseases, migraine is invisible. Suffering from migraine is often stigmatized as being lazy or weak and sufferers often find themselves to be alone  and misunderstood in their pain. Regardless of gender, reaching out to a community of migraine sufferers is a good way to find advice, support and share your experience. 

Women make up the most of these groups but it is time men are able to find their place in it too. As a migraine sufferer, you could also play a role in bringing light to this invisible illness through openly speaking up  about your condition. Don’t hesitate to discuss with men who can sometimes feel less entitled to join these communities.

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