Migraine is one of the most common neurological disorders and it impacts women more than men at a rate of 3:1. It is well established that sex hormones play an important role in the epidemiology of migraine. As children, boys and girls are equally affected, but the female predominance emerges after puberty which is why migraines in women are much more common than in men.
Many women who suffer from migraines note an increase in attacks in the perimenstrual period. Compared with non-menstrual migraines, menstrual migraines cause more impairment, are longer and are more likely to relapse within 24 hours, which significantly increases their burden.
Gender also plays a role in the chronification of headache, likely due to hormonal differences, and women have a higher prevalence of chronic daily headache than men. In addition, several studies have suggested that women have more frequent, more severe and more long-lasting headaches when compared with men. Women also experience more of the associated symptoms of light and noise sensitivity and nausea.
Women, pregnancy and migraines
For some women, a worsening of their migraines may be the first indicator of pregnancy. Migraines worsen during pregnancy because of factors such as the hormonal changes of pregnancy, nausea, dehydration, lack of sleep and stress. However, 60 to 87% of women with menstrually related migraine (MRM) improve in the second and third trimesters.
To minimize risks to the developing fetus and reduce pain and disability in women during pregnancy, approaches to treatment that do not include medication are recommended. Instead, lifestyle factors such as a healthy diet and regular sleep, maintaining good hydration, minimizing caffeine intake, avoiding triggers, moderate exercise and acupuncture, icepacks or heat are some ways to prevent and manage migraines during pregnancy.
Migraine symptoms often become apparent in the postpartum period as oestrogen levels rapidly fall. Breastfeeding may delay the return of migraines because it keeps oestrogen levels elevated.
Women, menopause and migraines
For many women, the period prior to menopause brings worsening migraines because the combination of fluctuating ovarian function with fluctuating hormone levels results in irregular periods, hot flushes, sleeplessness and difficulty concentrating. This chaotic hormonal combination can lead to higher migraine frequency and worsening severity, even for women who have suffered from relatively mild or infrequent migraine attacks in the past.
There is more information about women, menopause and migraines in this article.
Migraine is one of the most common neurological conditions and is the third most common disabling disorder globally. Women are disproportionately affected by a ratio of 3:1, compared to men, in part due to hormonal differences, with changes in oestrogen appearing to be the principal factor.
If you’re suffering from regualr migraines and you’re unsure of the cause or need a personalised treatment plan, reach out to our team at Migraine Specialist.
Note: Information on this site is not a substitute for professional medical advice
Migraine in Women, Broner MD et al, Semin Neurol 2017; 37:601-610