New YorkMigraines are twice as common in women as in men. But short of disabling headaches, women also suffer from headaches more than men. This year, a survey in the US asked respondents whether they had been bothered “a little,” “a lot,” “somewhere in between,” or “not at all” by headaches or migraines in the past three months. Women were almost three times more likely than men to say it bothered them “a lot.” So why do we women get headaches more?
While there are likely many contributing factors, studies suggest that one cause of sexism is hormones. But this doesn't explain all headaches or why some headaches affect men more than women. Here's what we know about it:
Women and migraines
One of the main types of headaches is migraine. It is characterized by pulsations that can range from moderate to severe, usually on one side of the head. It is one of the most common causes of inactivity among women aged 15 to 49 years. This headache can last anywhere from 4 to 72 hours. Before puberty, boys and girls are equally likely to get migraines, according to Anne MacGregor, a headache specialist at Barts School of Medicine and Dentistry in London, UK. But once puberty is reached, migraines become more common in women.
Women are two to three times more likely to get migraines than men, says Jelena Pavlovich, a neurologist at Albert Einstein College of Medicine in New York. This type of headache tends to affect women more in their 30s, “a particularly difficult period in life where the consequences of days lost to debilitating pain can be enormous.”
One possible reason for this gender discrepancy is that women generally experience more stress, whether from “work, social or family” obligations, according to Colleen M. LaHendro, a neurological nurse at Northwestern Medicine Lake Forest Hospital. Women also have more trouble sleeping than men, and fatigue sometimes causes these headaches.
Effect of estrogen
Some types of migraines are caused by hormones, especially sudden changes in levels of estrogen, which is mainly produced by the ovaries. It has been proven in scientific studies that estrogen plays an important role in the occurrence of migraines, which are more common in women than in men in the period between puberty and menopause. “For more than half of women with migraines, the onset and timing of pain is related to the hormonal flow of the menstrual cycle,” Pavlovich explains.
For example, many women experience migraines before and during their menstrual cycle, right after estrogen levels drop. Pavlovich's research has found that women who suffer from migraines tend to experience more severe declines in estrogen.
It's not clear why estrogen fluctuations trigger migraines, MacGregor explains. Estrogen does important things inside the brain, so hormonal changes must also trigger a cascade of factors that culminate in migraines.
LaHendro points out that women may also experience changes in the frequency of migraines during pregnancy, when estrogen levels tend to rise and fall. She adds that migraines often get worse during perimenopause, again due to estrogen fluctuations. But once menopause ends, hormone levels stabilize and many women notice that their migraines become less frequent.
Other types of headaches and their causes
In addition to migraines, women are 1.5 times more likely than men to experience tension headaches, which are mild to moderate and affect both sides of the head, LaHendro says. These headaches are uncomfortable, but not debilitating in and of themselves, and sometimes it feels like a narrow band is pressing down on your head.
It's not clear why tension headaches are more common in women, but stress may have something to do with it. Some studies suggest that these headaches are more common in women on the days near their menstrual cycle, suggesting that estrogen may also play a role. But other studies have found no evidence that hormones are responsible.
In contrast, according to MacGregor, men are more likely than women to suffer from so-called cluster headaches, which are rare but very painful headaches that affect only one side of the head and usually occur daily or almost daily over the course of several weeks. Or months. It's also not clear why these types of headaches are more common in men, but research suggests that they are more common in people who smoke or drink heavily, and men tend to drink and smoke more than women.
If you suffer from frequent headaches, “keep a diary and notice patterns,” McGregor recommends. In addition to stress, sleep, and hormones, there are other potential triggers to consider, including dehydration, changes in weather, medications, and alcohol. The National Headache Foundation suggests documenting when each headache begins and ends, its severity, any previous symptoms, potential triggers, and any medication taken to relieve it. Thus, the doctor will have the necessary information to adapt the treatment. The good news is that when it comes to treating headaches, “there are more treatment options now than ever before,” LaHendro says.
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