Men and Migraine

Key Points

• men sometimes avoid seeking medical care for their migraines
• 1 in 16 men have migraine
• men (and women) often mistake migraine for a sinus headache
• men who serve in the military can have migraines triggered by trauma and stress
• men who play contact sports can develop Post Traumatic Headache, which is sometimes confused for migraine
• migraine brought on by strenuous exercise is more prevalent in men than women
• often, men do not discuss migraine - yet ulcers, prostate cancer, erectile dysfunction get discussed frequently

Introduction

Migraine is often viewed as a female disorder but as many as 9% of men suffer as well. This misconception of a "female-only issue" can (at times) cause men to avoid seeking medical support and dismiss this debilitating neurological condition as just a headache. ¹

According to the American Migraine Foundation "migraine attacks can occur in a variety of different frequencies and severities, and come with a wide range of symptoms. By becoming aware of their symptoms, patients can work toward discovering the most effective treatment options for them. They also suggest that no two patients are alike. " ²

Famous men with Migraine include Elvis Presley, Albert Einstein, Ben Affleck, and now Kanye West. ³

As Dr. Paul Cooper, Headache Neurologist from London, Ontario pointed out in the book Navigating Toward Better Headache Care, - patients with recurrent headaches associated with nasal stuffiness and watery nasal discharge, without fever are much more likely to have chronic migraine. Vasodilatation (expansion of blood vessels) in the sinuses and nasal passages can lead to nasal stuffiness and watery nasal discharge, associated with the migraine headache, and these symptoms often respond to “sinus headache” compounds that contain a pain reliever and a decongestant—leading patients and primary care physicians alike to make a diagnosis of chronic sinus headache. ⁴

To add to this confusion, at times, some men experience migraine on the front of the face leading sufferers to suspect a less severe headache, such as a sinus headache.

In a large study performed by Harvard Medical School that was published in September 2016, men with migraine are more likely to have cardiovascular complications, such as heart attack and stroke, as a result of migraine. ⁵

Statistics

Globally, about 12% of the population suffers with migraine headache. Migraine is the most disabling headache disorder and is the 12th most common disability in women worldwide, and 19th in men. ⁶

Statistics Canada estimated that in 2017 nationally 3,303,727, and in Ontario 1,277,404 men suffered from migraine. ⁷

Migraine Again claims that 70% of men go undiagnosed and they have a 50% chance of passing it in to their children. ⁸

The Migraine Research Foundation reports that 1 in 16 men suffer from migraine. ⁹

Migraine differences between men and women

Migraine is often viewed as a female issue as the number of adult women suffering from migraine outnumbers men by over twice as much as women who suffer (roughly 18% of women versus 8% of men).

While the physical symptoms of migraine are generally the same between men and women, they often have different experiences. While women are far more likely to experience migraine resulting from hormone level changes, men are more likely to experience it from other physical and lifestyle triggers (see below). Men are also far less likely to report their migraine condition and seek treatment. ¹⁰

The following demographics scale was reprinted with permission from MigraineBuddy.com This scale allows us to view percentages of migraine between men and women, at various age-ranges.

Men who serve in the military are significantly impacted by migraine

Physical and emotional trauma often precedes the onset of Migraine – and soldiers get plenty of both, according to Migraine Again.. ¹¹

Veterans may be more likely to experience migraine attacks and headaches than civilians, and according to the American Migraine Foundation, they often experience physical and emotional trauma - which are huge triggers for migraine.¹²

According to the Canadian Institute for Military and Veteran Health Research (CIMVHR) in the Journal of Military, Veteran and Family Health, they suggest " that veterans experience a higher prevalence of chronic health conditions, post-deployment. Unfortunately, migraine, as a condition, was not listed. ¹³

At times, military men do not report their migraines to anyone for fear of damaging their careers. A recent posting by the National Defence and Canadian Armed Forces about a Corporal that recently returned from Kuwait, suggested that he continued to suffer from migraines post-deployment. ¹⁴

Concussion’s Relationship to Migraine and Post-Traumatic Headache

According to Dr. Bert Vargas, Director of the Sports Neurology and Concussion Program at UT Southwestern Medical Center, 95% of people with concussion will experience headache associated with that concussion. “Among those with headache, about two-thirds are going to have migraine features,” he said. Fortunately, that doesn’t mean that everyone will experience a post-traumatic headache, which is a headache that develops within seven days of an injury or after regaining consciousness. ¹⁵

World experts agree that a concussion does not require loss of consciousness.

While there are several subtle differences between migraine and post-traumatic headache, a large percentage of people with post-traumatic headache report experiencing symptoms similar to migraine—including headache, nausea, dizziness, insomnia, poor concentration, memory problems, and sensitivity to light and sound. ¹⁵

Stress and Migraines

Migraine and stress are strongly linked. Unfortunately, men experience stress quite frequently.

Stress is a very common migraine trigger for nearly 70% of people living with migraine and disorders that cause severe head pain. ¹⁶

According to the Migraine Association of Ireland - women are traditionally better at seeking help about the impact of stress and anxiety and they sign-up for stress reduction classes, such as yoga or meditation, more readily than men. ¹⁷

Alcohol and Men

Research suggests that red wine, and sometimes beer can be a trigger for migraine. We do know that men tend to drink more than women. One simple solution is to change your drink of choice.

Many consider alcohol to be a sure migraine trigger but its importance is still being debated.

The Migraine Association of Ireland further suggests that "white wines, stouts and spirits many have less of an effect than red wines and beers." ¹⁷

In a forward-looking study (PAMINA) published in 2007, Austrian researchers examined a large number of factors related to migraine. After an advanced data analysis, they found limited importance of nutrition, including alcoholic beverages in the precipitation of migraine. This work considered alcohol and other nutritional factors taken the day before onset of headache. ¹⁸

Migraine brought on by Exercise

Enough cannot be said about the advantages of regular exercise. But what happens if exercise is a trigger for your migraines?

Although some patients will experience that exercise triggers a migraine attack, increasing data from the research suggests that moderate regular exercise can be an effective way to reduce the frequency of attacks.¹⁹

We know that men typically tend to over-exert themselves when it comes to exercise. Research also suggests "over-exertion" can be a migraine trigger for some.

Some men's migraines are triggered from a workout in a gymnasium (probably due to florescent lighting, loud noises, and other factors) so the Migraine Association of Ireland recommends to "switch up your exercise routine to an outside class and if you feel a migraine coming, take the easy option of a walk that day and avoid worsening the condition with exercise." ²⁰

Conclusion

Male migraine sufferers are more likely to report depression as a symptom for their migraine. It has long been established that there is a strong link between migraine and depression. Migraine sufferers, especially chronic ones, often suffer from depression and tend to have a lower quality of life due to their condition. This is often due to lack of productivity, difficulties in holding down a job or maintaining an active family and social life due to migraines. Coping with migraines may be harder for men as, in most households, they tend to assume the role of the provider and the effects of suffering from such a disabling condition can lead them to feel helpless and depressed. ²¹

Ulcers, prostate cancer and erectile dysfunction get discussed frequently among men, especially with their health care provider. Even though research tells us that migraine in men is much more prevalent, these conditions are "perceived" to be more prevalent due to frequent TV ads and more extensive media coverage. ²²

When was the last time you saw an article in media about Men and Migraine?

by Brent Lucas, B.A. (Pysch)

Help for Headaches

London, Ontario

References

1. Migraine Association of Ireland, Men and Migraine
2. American Migraine Foundation
3. Migraine Again, 10 things you should know about in Migraine and Men
4. Cooper, P - Sinus Headaches, Navigating Toward Better Headache Care
5. Harvard Health Study, Feel your Pain, the health risk of Migraine in Men
6. Migraine Trust, Fact Sheets
7. Statistics Canada - 2017 Canadian population estimates
8. Migraine Again, Men and Migraine
9. Migraine Research Foundation, Statistics on Men
10. National Headache Foundation, How does migraine impact Men?
11. Migraine Again, Men and Migraine
12. American Migraine Foundations, Veterans and Migraine
13. Journal of Military, Veterans, and Family Health - February 2015
14. National Defence and Canadian Armed Forces, Ombudsmen 2018
15. American Migraine Foundation, Concussion, Migraine and Post Traumatic Headache
16. Migraine Again, Stress and Migraine
17. Migraine Association of Ireland, Men and Migraine
18. PAMINA - Austrian Researchers conduct large migraine study (Alcohol and Migraine)
19. Migraine Trust, Exercise and Migraine
20. Migraine Association of Irelands, Men and Migraine
21. MigraineBuddy.com - The Differences between men and women who suffer
22. Migraine Again, 10 things you should know about Men and Migraine