Hall of Fame Dallas Cowboys quarterback Troy Aikman has lived with migraine since childhood. His journey to diagnosis resembles that of many men with migraine who have been brought up to live with pain and not complain. Even though his sister was diagnosed with migraine and treated as a child, Aikman didn’t receive his diagnosis and treatment until age 40, five years after his retirement from football.
Aikman finally sought help as erratic sleep, exposure to smoke, and many long hours flying around the country for his work as a pro football commentator pushed Aikman’s migraine into overdrive.
Aikman’s story of underdiagnosis is not unique. The socially-ingrained male impulse to downplay suffering can hurt their health outcomes, and studies have determined that many men are not getting the information or care they need for migraine treatment. Some of this likely has to do with cultural standards of how each gender is supposed to tolerate pain, as well as the lingering stigma of migraine as a “woman’s disease” — despite the fact that approximately 9.1 million Americans living with migraine are men.
What’s Different For Men With Migraine?
Little is known about the way migraine operates specifically in men simply because it hasn’t been studied in great detail. Since migraine in men is so underrecognized, they are much less likely to be included in research trials.
What we do know is that sex hormones likely contribute to there being three times as many women with migraine as men. Boys and girls have a similar prevalence of migraine before puberty. After puberty, the prevalence increases in both genders, but far more in females than males, probably linked to the increase in estrogen levels. Further evidence supporting a hormonal link is seen when transgender women begin taking estrogen supplements, resulting in migraine at the same frequency as cisgender women.
- Men with migraine are at higher risk for stroke and heart disease. One study of men ages 40-84 found that migraine increases the risk of heart attack by 42%.
- Men’s reluctance to seek out medical care for headaches means they tend to overuse over-the-counter medicines, which lack the strength of prescription medicines to stop attacks. That puts them at higher risk for rebound headache syndrome, which increases the frequency and severity of headaches.
- Because migraine is more common among women, when men do seek help, many are misdiagnosed with headache types more common in men (such as tension-type or cluster headaches). If you’ve been seeing a doctor for headaches and they aren’t improving, seek a second opinion.
- Men cite exercise/physical exertion as a top cause of a migraine attack. (That gender differential could be because men don’t have one of womens’ top causes to compete with: menstrual cycling).
Steps You Can Take To Seek Treatment
Consult a doctor. A doctor can evaluate you for risk of heart disease and stroke, evaluate your medication plan, and evaluate you for preventive medications.
Lifestyle changes. More sleep, less alcohol, good diet and hydration. Prevention for exercise-induced migraine includes drinking water, no skipping meals, warming up and cooling down, and slowly building up the intensity and duration of your workouts.
Additional therapies. To treat depression, consider adding cognitive therapy; for stress reduction, try mindfulness techniques such as meditation or biofeedback.
Men have migraine, too. If you’re one of them, experts urge you to leave behind any cultural attitudes that are keeping you from the care and treatment you need. If you feel isolated, try searching for a support group or advocacy program in your area, such as the Coalition for Headache and Migraine Patients (CHAMP).
Acknowledge your need, open the door to help, and allow yourself the opportunity to live the fullest life possible.