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Open Access 03-01-2025 | Migraine | Review

Migraine in men

Authors: Mira P. Fitzek, Deirdre M. Boucherie, Tessa de Vries, Cleo Handtmann, Haniyeh Fathi, Bianca Raffaelli, Antoinette MaassenVanDenBrink

Published in: The Journal of Headache and Pain | Issue 1/2025

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Abstract

Background

Migraine is a common primary headache disorder, less frequently affecting men than women, and often regarded as predominantly a “women’s disease.” Despite this, migraine in men presents with unique characteristics in terms of symptoms, treatment responses, comorbidities, and pain perception. Historically, research has focused more on migraine in women, overlooking critical male-specific aspects.

Results

This review delves into the epidemiology, clinical presentation, and particular challenges of diagnosing and managing migraine in men. It addresses sex-specific triggers, hormonal influences, and comorbid conditions affecting migraine prevalence and severity in men. Additionally, the review evaluates current therapeutic strategies, underscoring the necessity for individualized approaches. Men with migraine often exhibit atypical symptoms compared to the ICHD-3 criteria and are less likely to report common associated symptoms. They also tend to have fewer psychological comorbidities, respond more favorably to pharmacological treatments, yet are less likely to seek medical support. The reasons for these sex disparities are complex, involving biological, psychosocial, and cultural factors, such as brain structural differences, differences in functional responses to painful stimuli, hormonal effects, and behavioral influences like adherence to masculine norms and stigma.

Conclusion

Men are underrepresented in clinical migraine research. In contrast, preclinical studies often focus solely in male animals as a result of various misconceptions. This disparity necessitates greater focus on sex-specific aspects of migraine to enhance diagnosis, treatment, and research. Addressing stigma, increasing healthcare access, and ensuring balanced sex and gender representation in future studies is crucial for a comprehensive understanding and effective management of migraine for all patients.
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Metadata
Title
Migraine in men
Authors
Mira P. Fitzek
Deirdre M. Boucherie
Tessa de Vries
Cleo Handtmann
Haniyeh Fathi
Bianca Raffaelli
Antoinette MaassenVanDenBrink
Publication date
03-01-2025
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2025
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-024-01936-7

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