The reasons for this are myriad; one being that women are much more likely than men to report pain to doctors. The physiological reasons, however, for an increased incidence of migraines in women, are much more complex.
A study published in Frontiers in medical biosciences (2018) goes some way to explaining this phenomenon. The research for this study was led by Dr Artero-Morales. The researchers noted that ‘the functionality of the somatosensory, immune and endothelial systems seems modulated by sex hormones, as well as by X-linked genes differentially expressed during development’ Put simply, female genetics and hormones plays a large role in migraines. They increase your chances of developing migraines; if you do suffer a migraine, they also make them more painful, and longer lasting.
HOW DO SEX HORMONES AFFECT MIGRAINES?
The pathways involved in the induction and magnification of migraines are not completely understood. Migraine pathways should be seen as a spider’s web of connections, with cascades of pathways triggering each other in a non-linear direction. Within this tangled web, researchers have noticed the importance of the trigeminal nerve. Its exact function in migraines is a topic of debate, but its place as an important migraine pathway is not in dispute. Located behind the eyes, the trigeminal nerve becomes very active when a migraine attack occurs. Interestingly, artificial stimulation of this nerve has been shown to assuage attacks.
In the context of this study, Dr Artero-Morales and his team observed that the presence of female hormones (Estrogen, Progesterone, Prolactin and others) causes the trigeminal nerve to become more susceptible to activity, which leads to a migraine attack. The hormones work on a molecular level to ‘sensitize’ the nerve, allowing it to become more reactive to extrinsic stimuli. Fluctuations of female hormones have the same effect, so it is not simply a direct correlation between female hormone concentration and migraine attacks.The male hormone, testosterone, has the opposite effect on the nerve, making it less sensitive to outside stimuli. With female hormones acting as migraine triggers and male hormones acting as preventative medicine, one of the reasons for such a large gender disparity in migraines becomes clear.
WHY ARE MIGRAINES MORE ERRATIC IN WOMEN?
Female sex hormone levels are constantly fluctuating in a woman’s body. They fluctuate every month, during the menstrual cycle; they also fluctuate during a woman’s life, from puberty, through pregnancy to the menopause. These fluctuations mean migraine incidence rates for women are more cyclical and age specific than men. A woman might notice that she will experience a peak in migraine activity before and after her period. Women who suffer with menstrual cycle related migraines will also be more likely to suffer with menopause related migraines.
With female hormones acting as migraine triggers and male hormones acting as preventative medicine, one of the reasons for such a large gender disparity in migraines becomes clear.
FINAL THOUGHTS
It is important to note the observations of this study are in their infancy and require further investigation. It is a positive sign that much effort is being directed to address the gender disparity in migraines. As researchers learn more about how female hormones interact with migraine pathways, they will be able to tailor treatment to specific gender specific pathways, and hopefully help narrow this male/female disparity in migraine incidence rates. Right now, even if we are not at the stage where this information can be translated to novel therapy, you as a migraineur can only benefit from understanding why you might suffer with migraines at certain times and not at others. Knowledge is the key to empowering and taking control of your health.
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– Clearmymind