Sex differences in the epidemiology, clinical features, and pathophysiology of migraine

Migraine affects women two to three times more than men. Women experience longer attacks and increased headache recurrence. They also report greater disability and longer recovery times. Comorbidities, such as asthma, anxiety, and depression, often accompany migraines. These conditions increase disability for both sexes. Migraine with aura is a risk factor for vascular disorders, especially in women. However, research is limited regarding men's comparative risk for these disorders. Female sex hormones significantly influence migraine risk and features, explaining observed sex differences. Genetic variance could also contribute to these differences. While migraine is often recognized in women, it is frequently underdiagnosed in men. This underdiagnosis leads to poor management for men. Additionally, fewer men participate in clinical trials, which affects treatment development. Understanding these differences is crucial for improving migraine care and outcomes for all patients. Clinical relevance: This research highlights the need for better migraine diagnosis and management in men.