Migraine in men
Important information
Migraine is more common in women than men. By contrast, cluster headache, another primary headache disorder with some similar features to migraine, is more common in men than women.
During migraine attacks, women report more non-headache symptoms like nausea, vomiting, sensitivity to light or sound and attacks of longer duration than men. Migraine with aura is more common in women than men. These differences are mostly attributable to hormone changes in women, from puberty to menopause.
This section looks at specific issues for men with migraine.
Migraine in men
Men with migraine are less likely to be diagnosed with migraine, which means migraine in men is not always optimally managed. Men are less likely to use acute or preventive medications than women, probably because they are less likely to see a health professional for migraine.
Migraine is sometimes (wrongly) considered to be a female disease, which contributes to the underdiagnosis of migraine in men. Women report higher migraine-related disability than men, but this is frequently measured using the Migraine Disability Assessment Score (MIDAS).
This is based on five questions, including inability to do household work and missing family or social activities. Women with migraine are significantly more likely than men to score highly on these questions, and women are also more likely to undertake household chores and family responsibilities, which could explain this difference.
Because migraine is more common in women, many clinical trials of migraine treatments have included more women than men, raising the possibility that there may be differences in treatment results for men. Sex-specific differences in migraine preventive treatments have not been studied, except for anti-CGRP monoclonal antibodies where no difference in safety or effectiveness by sex has been found. Men appear to tolerate and respond as well or better to triptans than women.
The role of the sex hormone testosterone in migraine is not well understood but may be protective. For example, testosterone levels are lower in men with chronic migraine than men without migraine.
