If you read migraine literature, you keep brushing up against the statistic that women are much more likely to get migraines than men. Very rarely is it ever explained WHY. I have always assumed it was hormonal, and vaguely remember hearing that the wise men of medicine in the past believed it was due to women’s naughty wondering wombs, or our uterus radiating hysteria… ugh.
I decided to go looking to see if I could find a definitive answer – and from what I can tell – it probably does have a fair bit to do with the parts of us that make us female… hysterical or not.
So, if details of menstruation are not your vibe – feel free to take a break from reading today… or head over to my past post “Give yourself a hug” which shares some kindness postures AND uses sample power poses to help you test out which hormones you might have most of.
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First up – DISCLAIMER – I am not a doctor, so please do NOT use any information on this blog as a substitute for medical advice – but DO see a doctor for information that is current and tailored to your personal situation.
OK then…
An article on TheConversation.com (here) notes that the distribution of migraines in young people is pretty much even between boys and girls. It is after puberty, however, that the numbers start to diverge and women are 2 to 3 times more likely to get migraines. Which suggests hormones are a BIG part of what’s going on.
Menstruation, pregnancy, perimenopause, and using hormonal contraceptives or HRT are all times when hormones change… and are all times that migraines can get better… or worse.
In a WIRED article, the author noted hormones were the main culprit for the gender imbalance in migraines, specifically: “A sudden drop in estradiol—a potent form of estrogen—is thought to play a key role.” That’s why many women have cyclical migraines a few days before menstruation each month, or during perimenopause when hormones are ‘erratic’.
[Tick the box for me – in my 40s my occasional migraines became monthly, and by the time I was 50, perimenopause kicked in and wow, did I get sick; alongside all the hot flushes and mood swings, my migraines merged until I was in daily migraine pain.]
The article then goes on to say that estrogen isn’t acting alone. As estrogen drops, so does serotonin, (which influences pain sensitivity). Add to this other triggers such as exhaustion, hunger, dehydration, or stress, and the chances of a migraine increase.
Then there’s still another issue that we’re still learning about – how estrogen reacts with calcitonin gene-related peptide (CGRP), which is a chemical that nerve cells use to “talk” to each other, and which dilates blood vessels to increase blood flow. It’s one of the main reasons new medication research is in this area.
According to a PubMed article, women apparently have higher levels of CGRP than men, so when we add fluctuating estrogen levels we’re automatically more predisposed to migraine symptoms.
But it doesn’t top there!
Progesterone might also be problematic. Apparently, activation of progesterone receptors in the brain is a possible reason that our susceptibility to pain increases further. Whilst men DO have the progesterone hormone in their body, they don’t have it in the quantities that women do.
Another website, Medical News Today, suggested that there was an additional reason. They believe that neurons found in a cranial nerve (known as the trigeminovascular nerve) are influenced by hormones and interact in a way that makes the nerve cells more sensitive. By extrapolation, when there is a trigger (hunger, dehydration etc) the female brain is more sensitive to that trigger. The article then talks about estrogen research, but notes it is mostly conducted on animals (which makes me sad (more here)) and so we still can’t “jump to conclusions” about why women are more affected than men.
The ABC, an Australian newspaper, noted one last potential reason why the numbers are skewed – based on maths: given that it is possible that gene mutations related to migraine risk are passed on by the X chromosome, and women carry two copies of the X chromosome, that makes their risk of inheriting the condition mathematically higher.
Whilst all of the research to date and underway should diminish the idea that migraine belongs to “hysterical” or “sensitive” women… (so you can get lost all you condescending old advertisers I’ve blogged about before (here))… overall, they still acknowledge that men are more likely to receive adequate treatment and medication… in other words… their pain is taken more seriously.
UGH.
As with so many migraine-matters… it’s not entirely clear what’s going on… or to be more accurate, there’s A LOT going on, so hormones might not be the main cause, or only cause, of your migraines.
Best advice – don’t just google your condition, talk to a doctor – preferably one who specializes in migraines.
Take care taking care, Linda x
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PS – if you’re curious about conversations around female hormones, there are a couple of past posts on my blog that might also help: Hysterectomies and migraines / Menopause and migraines / “Not tonight honey – I have a headache” / What really causes migraines?
PPS – my blog buddy over on Roaring Meg often has some great links to migraine articles that keep me up to date with the latest in neuro-science, you can check her out here: Roaring Meg – Navigating The Neuro-Seas
The Mindful Migraine 
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