Gender-related differences in migraine

Abstract

Migraine is considered mostly a woman's complaint, even if it affects also men. Epidemiological data show a higher incidence of the disease in women, starting from puberty throughout life. The sex-related differences of migraine hold clinical relevance too. The frequency, duration, and disability of attacks tend to be higher in women. Because of this, probably, they also consult specialists more frequently and take more prescription drugs than men. Different mechanisms have been evaluated to explain these differences. Hormonal milieu and its modulation of neuronal and vascular reactivity is probably one of the most important aspects. Estrogens and progesterone regulate a host of biological functions through two mechanisms: nongenomic and genomic. They influence several neuromediators and neurotransmitters, and they may cause functional and structural differences in several brain regions, involved in migraine pathogenesis. In addition to their central action, sex hormones exert rapid modulation of vascular tone. The resulting specific sex phenotype should be considered during clinical management and experimental studies.

The Development of Mindful-Based Dance Movement Therapy Intervention for Chronic Pain: A Pilot Study With Chronic Headache Patients

“…In addition, it is important to acknowledge that 60% of the study participants had comorbid pain states, which may have influenced the study results. The comorbidity of other pain and mental states (depression and anxiety) is characteristic of women with migraine diagnosis and has been reported in previous chronic pain studies (Allais et al, 2020;Xu et al, 2020), suggesting that the mechanism of central sensitization may be a substrate or consequence of comorbidity (Ashina et al, 2018).…”

A Link Between Migraine and Prolactin: the Way Forward

“…It remains to be determined how several factors interacting with each other to create one specific response and how this response can guide for treatment strategies to be specific and safe. Most studies focus on exploring role of one factor at a time, and this limits the understanding of complex relationship that exists between one and other hormones, influential role of age-related factors, and critical role of comorbid conditions in migraine [ 2 ]. It is immature to consider that sexual dimorphism of migraine can be explained by one factor.…”

“…Migraine is a common incapacitating disorder that often presents with autonomic and neurologic symptoms of severe headaches that occur recurrently [ 1 ]. Women between the ages of 30 and 45 years, in particular, are affected, with as many as 25–30% of the general female population affected [ 2 ] compared with 8% of men affected, and therefore, the burden of this disorder is higher in women [ 3 ]. There are several interpretations for the sexual dimorphic etiology of migraine [ 4 ], and hence, proposals for sex-based treatments of migraine have emerged [ 5 ].…”

Clinical significance of serum sex hormones in postmenopausal women with vestibular migraine: potential role of estradiol

“…Migraines usually have a higher incidence, frequency, duration, and disability of attacks in women than in men, which might be related to the hormonal milieu and its modulation of neuronal and vascular reactivity. 14 Nonobese men with migraine show markedly increased serum estradiol levels, indicating a relationship between sex hormones and migraine. 15 For postmenopausal women, sex hormones and many other factors have changed at this stage of life.…”