Migraines: Men vs. Women

It is a fact that women suffer migraines more than men. It is a fact, according to the UCLA Department of Neurology, that women are three times more likely to have migraines than men and that 18-25% of the female population suffers from migraines.[1] These are widely known and accepted statements, but the question is, why are women more susceptible to migraine than men?

Brain Excitability and CSD

A large portion of migraines are caused by brain excitability, and a brain reaction called cortical spreading depression (CSD).[1] CSD is a dramatic wave of activity that spreads across the surface of the brain causing inflammation and pain. During this wave, blood flow increases and then decreases, and changes in the brain occur. These changes in the brain and in blood vessels are what cause not only migraine pain, but the other physical aspects of migraine including nausea, sensitivity to light and noise, and dizziness. In a lab study, it was found that females have a significantly lower threshold to CSD when compared to males in the study, meaning that if CSD brain excitability occurs, women are more likely to suffer the effects than men.


Menstruation is a notorious migraine trigger. Research shows that the primary trigger for migraine during menstruation may be the withdrawal of estrogen. “Just before your period, estrogen levels drop and this affects the brain’s neurotransmitters and the sensitivity of the receptors that pick up their messages,” says Dr. Judith Reichman, MD of Obstetrics and Gynecology at Cedars-Sinai Medical Center in Los Angeles, CA. “Blood vessels dilate, nerves are sensitized and muscles go into spasm,” thus causing the headache.

Common Triggers Different for Men and Women[3]

Chocolate, cheese, alcohol, and caffeine are all common triggers for migraine in both men and women, but the way they are metabolized in the body differs greatly in men and women. “For dietary and pharmacologic triggers (such as caffeine or alcohol), the same dose will affect men and women differently,” says Dr. Kevin Sperber, assistant professor of Clinical Rehabilitation Medicine at Columbia University College of Physicians and Surgeons.

It’s a Guy Thing/Pain Perception

Dr. Desiree Thomas, a neurologist at Kelsey-Seybold Clinic in Houston, Texas points out that the way male brain processes pain information is different than the way a female brain processes the same pain. Near identical symptoms can be present in a male and female, but it is the distinct way the brain perceives and reacts to pain that results in an awful migraine or fleeting headache. Social norms as well as biology may account for differences in the way men and women think about and talk about pain. Studies have shown that women are more likely than men to seek care for pain, and that culturally it is more accepted for women to have pain complaints. Men are more likely to have a severe and disabling headache condition before seeking care from a physician. Studies show that when experiencing pain, the activity in women’s brains is very strong in the emotional areas of the brain, and men’s brains show more activity in the area that is responsible for personality expression, decision making and moderating correct social behavior.

Triggers →

For a proper diagnosis, talk to your doctor about the headache pain you are experiencing or contact me to set up a migraine consultation.

Phone: 646.648.3793

E-mail: drhalpern@audreyhalpernmd.com

1. University of California – Los Angeles. “Why Women Get More Migraines Than Men.” ScienceDaily 8 August 2007. 26 August 2009 www.sciencedaily.com/releases/2007/08/070806094703.htm

2. Dr. Judith Reichman, MD of Obstetrics and Gynecology at Cedars-Sinai Medical Center in Los Angeles, CA

3. Dr. Kevin Sperber, assistant professor of Clinical Rehabilitation Medicine at Columbia University College of Physicians and Surgeons health.howstuffworks.com/women-more-migraine.htm/printable

4. Dr. Desiree Thomas, neurologist at Kelsey-Seybold Clinic in Houston, Texas health.howstuffworks.com/women-more-migraine.htm/printable

5. M.Hobara, “Beliefs about appropriate pain behavior: cross-cultural and sex differences between Japanese and Euro-Americans” European Journal of Pain, Volume 9, Issue 4, Pages 389, 393

6. Brain Imaging Reveals Gender Differences In How Individuals Cope Under Stress
Article URL:www.medicalnewstoday.com/articles/89352.php

7.Headache: The Journal of Head and Face Pain, Volume 41 Issue 7, Pages 698, 703

“Gender Differences in Treatment-Seeking Chronic Headache Sufferers”
Dawn A. Marcus, MD
From the Pain Evaluation & Treatment Institute, Pittsburgh, Pa.

Copyright American Headache Society