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- Trade Journal
Migraine: Differences Between Males and Females
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Migraine is more prevalent in women, who are more likely to seek medical help for their headaches and to participate in clinical trials, as compared to similarly affected men. However, men with migraine may be underdiagnosed or misdiagnosed and, therefore, inappropriately treated. This review outlined the sex differences in epidemiology, clinical features, and pathophysiology in this female-predominant, but male-afflicting, primary headache disorder. Although data from the Global Burden of Disease Study 2015 found that migraine is two to three times more prevalent in adult women than in men, migraine is equally likely to occur in both sexes prior to puberty. Age-specific prevalence of migraine, both without and with aura, peaks at a younger age in boys than in girls. Then, girls in their teens develop migraines more frequently than do teenaged boys. Migraine incidence peaks in the late teens in boys at 6.2 cases per 1,000 human-years and in their early 20s in women at 18.2 cases per 1,000 human-years. The rate of increase in migraine prevalence is dramatically higher in women in their late teens and young adulthood than it is in similarly aged men, who are more likely to have longer-lasting periods of migraine remission after childhood.
Clinical features of migraine appear to be relatively similar in men and women, although women report longer duration of attacks. Migraine with aura, in about 8% of women and 4% of men, occurs in the same ratio in both sexes as does the twice-as-prevalent migraine without aura. Disability associated with migraine is greater in women (fourth leading cause of years lived with disability, according to the Global Burden of Disease Study 2015) than in men (eighth leading cause), possibly related to longer duration of attacks and higher relapse rates, in combination with multiple household, childcare, and employment responsibilities for women. Despite migraine’s...