Men with migraine face significant physical, psychological, and social challenges. The chronic and often severe nature of migraine symptoms disrupts all aspects of their lives, including work, relationships, and mental health. Despite the availability of treatments, early and effective management is often hindered by stigma, healthcare system constraints and insurance barriers.
Men face unique stigma and gendered expectations that discourage them from openly discussing their migraine attacks or seeking help, exacerbating isolation and potentially delaying care—all of which increases their risk of disease chronification.
We hope the answers to the questions below shed some light on the struggles men with migraine face, and help guide them on how best to manage treatment.
Watch this video with Dr. Thomas Berk as he talks about the many ways migraine impacts men.
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"By speaking up, you can not only break the silence surrounding men's migraine experiences, but also potentially interrupt the cycle of worsening attacks. Being open about your condition can help prevent the progression of migraine symptoms."
—Thomas Berk, MD
"Find your tribe. Find other people who understand you and have what you have. Find a place where you can get advice and share advice and find out ways to deal with migraine the best you can.”
—Man with Migraine
"There’s a stigma around men with migraine that we're weak or not serious, and many men feel they have to ‘man up’ and tough it out, often hiding their pain because society expects them to be the protector and the rock, not someone who suffers from an ‘invisible’ illness.”
—Man with Migraine
General Information
Approximately 10 million men in the United States live with migraine. This represents about 25% of the total 40 million people with migraine in America.
—Dr. Berk
T ratio of men to women with migraine changes throughout different life stages:
- In early grade school (ages 6-8), it's about 50/50 boys and girls
- During reproductive ages, it shifts to a 3:1 ratio of women to men
- In older adults, there may be a slight trend towards more men having migraine, potentially related to neck issues
The hormonal fluctuations during reproductive years are a key factor in the higher prevalence of migraine among women during that period.
—Dr. Berk
The perception of migraine as a "women's disease" stems primarily from the 3:1 ratio of women to men experiencing migraine during reproductive ages. During this period, the overwhelming demographic of migraine sufferers is female, which has shaped public perception.
Additionally, marketing and media representations have historically depicted migraine as primarily affecting women, further reinforcing this stereotype. The hormonal fluctuations that trigger migraine in women during reproductive years contribute significantly to this skewed perception, even though migraine affects men in substantial numbers across different age groups.
—Dr. Berk
For the most part, there are no vast differences in migraine subtypes or symptoms between men and women. The subtypes like migraine with or without aura, and vestibular migraine, do not show significant variation between genders.
The primary difference is the incidence of migraine, not the symptoms or severity.
—Dr. Berk
Diagnosis and Treatment
Yes, men are indeed less likely to go to a doctor and be proactive about their health. In general ...
- Men typically wait longer to seek medical help
- Men tend to bear symptoms for longer periods
- Men are less open about discussing their health issues, even with family members
- Many men believe a doctor visit won't be helpful or will just result in being told to "take two aspirin"
- There's often a sense of shame or stigma around admitting health problems
This tendency is not unique to migraine, but common across many men's health conditions. Men are more likely to try to "tough it out" and delay seeking medical attention, which can lead to delayed diagnosis and treatment.
—Dr. Berk
Most people don't even know what they're experiencing or understand migraine as a condition. It's very important for doctors to:
1. Provide a clear diagnosis
2. Explain what migraine actually is
3. Define the different types of migraine
4. Discuss the natural history of the disease
5. Explain that "migraine begets more migraine" - meaning frequency can increase if not properly managed
Simply educating patients about the nature of migraine, its potential progression, and the importance of early intervention can make a significant difference. Providing comprehensive information helps patients understand the seriousness of the condition and the potential consequences of ignoring symptoms, which can motivate them to seek appropriate treatment and management.
—Dr. Berk
Overall, the core treatment approaches and migraine subtypes remain largely similar between men and women. There are some subtle differences in treatment responses between men and women, with certain medications causing different side effects.
For example, Lisinopril (blood pressure medication) is more likely to cause cough in men. Gastrointestinal side effects are more common in women. Blood pressure changes with CGRP medications tend to be more noticeable in men around 30-45 years old.
While there are minor variations, the fundamental approach to migraine treatment remains consistent across genders, with individual customization being the most important factor.
Life Impact and Lifestyle Modifications
The best way for men to communicate migraine's impact is by being vulnerable and authentic. Specifically ...
1. Be open about what you're experiencing
2. Explain that migraine is more than just a headache
3. Describe how the condition truly affects your ability to function
4. Share that when you experience a migraine, all you want is to return to normal
5. Communicate that you're not complaining, but seeking a solution
Saying you have a problem doesn't mean you're complaining - it's actually the first step toward finding a solution. By being honest about the challenges migraine creates in your life, you can help others understand its real impact and potentially get the support and accommodations you need.
The key is to be direct, honest, and focus on how migraine genuinely disrupts your daily life and ability to work, engage with family, and maintain your quality of life.
—Dr. Berk
Regular exercise is very helpful for preventing migraine attacks—some studies show that 30-45 minutes of exercise, 3 times a week, can be almost as beneficial as preventive treatments. Start with simple activities like walking around the block and gradually increase intensity.
During a migraine attack, physical exertion will worsen symptoms though and some people have headache subtypes triggered by specific exercises.
Important Safety Note:
- If vertigo or severe symptoms develop rapidly during exercise (zero to maximum pain in under 60 seconds), seek immediate medical attention
- A hallmark of migraine is that physical exertion worsens symptoms during an attack
Exercise is beneficial, but listen to your body and modify activities as needed.
—Dr. Berk
Stigma
Recognize that migraine is a genetic predisposition, not caused by personal fault. Most migraine triggers are unavoidable parts of life. Attacks typically result from multiple triggers happening simultaneously, not just one factor.
A good doctor should educate you about your condition, provide treatment options, and show empathy, not blame you for your symptoms.
If a doctor is blaming lifestyle choices and not addressing the actual condition men can try to:
- Explain that migraine is not something they caused
- Request a comprehensive evaluation
- Check for underlying medical factors (like vitamin levels)
- If the doctor continues to blame you and dismiss your condition, it may be time to find a new healthcare provider.
f your doctor is consistently telling you it's "all your fault" and not providing proper medical care, it might be best to move on and find a healthcare professional who understands migraine as a legitimate medical condition.
—Dr. Berk
Some workplaces are challenging, but many will be willing to make adjustments if approached professionally and with clear documentation.
Start by getingt a formal letter describing your medical condition. Work with your healthcare provider to outline specific, reasonable accommodations and be prepared to negotiate and document your needs. Most employers will work with you if accommodations are reasonable
Accommodations that can be helpful include:
1. Remote work options
2. Flexible scheduling
3. Adjusting work hours to avoid high-stress or high-commute times
4. Coming in early or staying late
5. Access to a dark, quiet room during attacks
6. Ability to rest for 30-60 minutes during an attack
7. Taking medication and resting before returning to work2. Some states require employers to make reasonable adjustments
—Dr.Berk
It usually involves basic things like being allowed to take their medication at school, have their sports drink to be able to hydrate, use the bathroom, have snacks. Other accommodations that may be needed are extra time to do tests, extra time on assignments, breaks during the school day when needed.
We try to stay away from blanket excuses for school absences, because we want them to function, and being at home and missing more school creates a negative loop where you miss school, get stressed out about all the work to make up, and then the stress actually can be a trigger for the migraine attacks, so they miss more days. School can become a negative place to be because they always feel like they’re behind, so we focus on how we can make school a more tolerable place versus not being there at all. When their functioning is significantly impacted at school we will suggest a formal plan like a 504 plan.
—Dr. Slater
There's a problematic notion of "manning up." Society often expects men to appear strong and invulnerable. To suppress their symptoms
and avoid seeking help. This attitude is unhealthy and creates additional stigma
To best manage this belief, men should:
- Be direct and specific about symptoms
- Demand comprehensive evaluation
- Seek providers who understand migraine as a legitimate medical condition
Men need to break the silence about their health experiences. By sharing their stories, they can challenge stereotypes about masculinity and help demonstrate that seeking help is a sign of strength, not weakness.
Being open about your experience can interrupt the cycle of stigma and potentially help manage your condition more effectively.
—Dr. Berk
About Dr. Berk
Thomas Berk, MD FAHS,
is the Vice President of Clinical and Medical Director of Neura Health and a neurologist and headache specialist based in New York City. A former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine, he has over 12 years of clinical experience. He graduated from the NYU Grossman School of Medicine and completed his neurology residency at NYU as well. He completed a headache fellowship at the Jefferson Headache Center in Philadelphia. He is a Fellow of the American Headache Society and has been on the Super Doctors list of rising stars for the past five years.
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