Why do migraines disproportionately afflict women?
Hormones, probably. About 18 percent of women suffer from migraines, compared with just 6 percent of men. Doctors have proposed several explanations for the disparity, including different levels of external stress and gender-related differences in the psychological response to pain. The best research, however, now suggests that sex hormones are to blame, and loads of circumstantial evidence support this theory. In women, the headaches typically begin after puberty and tend to decrease in both frequency and intensity after menopause. (Migraines are one of the few neurological disorders to subside with age.) They are also more common during menstruation and less common during pregnancy. Intriguingly, doctors treating male-to-female transgendered people have noticed that after their patients begin hormone therapy, they start to experience migraines with the same frequency as genetic females.
Although the research is still unsettled, there is growing scientific evidence that estrogen is the primary culprit. Migraines occur when inflammation around the brain triggers trigeminal nociceptors—cells responsible for pain sensations around the face—to transmit chemical signals. Nancy Berman and Kenneth McCarson, neurology researchers at the University of Kansas Medical Center, have shown that in mice these cells have estrogen receptors. Also, rats exposed to estrogen exhibit significantly worse migraine symptoms—except for nausea, since rats don't vomit—than their estrogen-starved counterparts at the same level of inflammation. At a biochemical level, they've documented changes indicating that pain signals are stronger when estrogen receptors are activated. Such evidence suggests the possibility that men might experience the inflammation associated with migraine just as often as women but their pain receptors have a less forceful response to it.
Interesting, but my favorite part is the male-to-female "transgendered" people. A guy's junk is removed, and he's pumped with hormones, but doctors refer to his status as a social construction--"gendered." Hilarious.
Migraines are typically a disease of middle age - 30s-50s - which does not fit with estrogen being the main cause.
ReplyDeleteI suspect these researchers don't know much about the clinical aspects of the disease and are just fitting the 'facts' around their technical expertise: that is normal for modern medical research.
I think doctors would still screen a male-to-female transsexual for prostate cancer, for example.
ReplyDeleteBesides, with all the weirdness around us, it's useful to have words for, as Derbyshire says, the fact and the act of sex/gender.
Migraines are typically a disease of middle age - 30s-50s - which does not fit with estrogen being the main cause.
ReplyDeleteMy sister used to get bad migraines in her teens.
Wikipedia has a graph of migraines by age and sex. They peak in the teenage years, and are a lot more common among females of all ages.
ReplyDeleteGosh, there's a lot of helpful information above!
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Migraine is a chronic disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic symptoms. The word derives from the Greek ἡμικρανία (hemikrania), "pain on one side of the head", from ἡμι- (hemi-), "half", and κρανίον (kranion), "skull".
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ReplyDeleteMigraines typically present with self–limited, recurrent severe headache associated with autonomic symptoms. About 15-30% of people experience migraines with an aura and those who have migraines with aura also frequently have migraines without aura. The severity of the pain, duration of the headache, and frequency of attacks is variable. A migraine lasting longer than 72 hours is termed status migrainosus.
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