Migraine: Why this type of headache is often misunderstood in men

Migraines mainly meet women – you think. But men also suffer from the neurological disease. Often it remains undetected or is treated incorrectly because symptoms are missing or are different from women. The neurologist and headache expert Professor Christian Maihöfner explains how migraines really show in men, why many have not received any help for years – and how modern therapies today change the lives of those affected.

“Migraines are considered a women’s disease – men are certainly affected,” says Christian Maihöfner, headache expert of the German Brain Foundation. Migraines appear in women two to three times more often. But every 15th to 20th man also falls ill in the course of his life. Often the diagnosis of men is made late, Maihöfner knows from his everyday clinical life as a neurologist in the Fürth Clinic: “If a man with headache comes into practice or clinic ambulance, you think of too much stress and tension headache – and not migraines.” One reason for this: the symptoms are sometimes different from women and therefore more difficult to classify.

The differences in the frequency of migraines between men and women begin in puberty, which indicates hormonal influences. Testosterone could have a protective effect against migraines. The thesis is supported by study data, according to which men with chronic migraines sometimes have lower testosterone levels. Testosterone apparently also influences the sensitivity to pain in men and could explain why migraines not only occur less often, but often less intensely.

Women rather describe the typical one -sided, pulsating headache. Men often have more diffuse complaints. “Many men describe a bilateral, i.e. holocephalic pain,” says Maihöfner. They also report less often about typical accompanying symptoms such as nausea, vomiting, light or noise sensitivity. This often makes the diagnosis difficult.

Instead of the typical accompanying symptoms, men have much more frequently neurological side effects – so -called Auren. “Aura” comes from the Greek term “Aurora”, the goddess of dawn; The dawn announces the day – and the neurological aura the acute migraine attack. These can be visual disturbances, feelings of tingling in the arms and legs, language disorders or even paralysis – sometimes even without a headache. “This makes things particularly tricky, because instead of migraines, for example, a stroke or epilepsy is thought of,” says Maihöfner. Important additional examinations such as EEG (electroencephalogram) and MRI (KERSPIN) help to recognize the various neurological diseases.

With migraines you first think of headaches. It has been clear for some time that a migraine is more. The so -called Prodrom shows the migraines days in advance: with mood swings, cravings, even with creativity pencils. “Many affected people already know: Okay, now I will soon get headaches again,” says Maihöfner. This protrom phase seems to be more pronounced in men-just like the so-called post-drome. This means that after a migraine attack you can still have accompanying symptoms regardless of the pain. These also seem to be more common in men.

Even if many men call chocolate or cheese as a trigger: “The craving for special foods is more the result of the Prodrome, the preliminary phase of migraines,” says Maihöfner. Well -known typical triggers in men are:

Above all, little sleep and alcohol play a larger role in men than in women. Anyone who regularly develops inexplicable headaches in this context should search for professional help.

“The therapy has made great progress in recent years,” says Maihöfner. In addition to the proven triptans, there are new medication that specifically intervene in the migraine: so-called CGRP antibodies. They block a certain messenger substance (CGRP) that is involved in the pain in the pain – with often astonishing success. “For example, one of my patients had 15 migraine days a month – with the current medication, it is only one or two,” says Maihöfner. The costs for modern therapies bear the health insurance if other procedures are exhausted.

In addition to drug prophylaxis, regular endurance sports and relaxation procedures help to contribute to the fact that migraine attacks do not even appear. Stress management strategies, biofeedback and behavioral therapy are also included. “Men in particular often benefit from a structured therapy concept,” says the expert.

“Men are trivializing their symptoms – not from despite, but out of habit,” says Maihöfner. Many affected people would ignore the symptoms or try to “bite through”. They often only searched for help when the suffering is massive – the relationship suffers, those affected no longer work in the job. In addition, men often don’t feel taken seriously with the diagnosis of migraines. “There is a lack of role models, public perception. Migraines are still considered a women’s disease,” explains the neurologist. Men could benefit particularly – if they go into a specialized headache consultation at an early stage. “I would like more awareness among experts and those affected: men can also have migraines – you should always think about that in clinical practice.”