Migraine in women: why women are more affected and what helps

If you’ve noticed that migraine seems to affect women more often than men, it’s not, for lack of better words, all in your head. Migraine, a neurological condition that can cause recurring attacks of head pain and other symptoms, affects women about three times as often as men. Why? Fluctuating hormones. 

Changes in estrogen across the menstrual cycle and throughout different life stages, namely the menopausal transition, can affect migraine patterns in some women. But that doesn’t make migraines any less disruptive. They can affect everything from your ability to work, exercise, sleep, and enjoy social gatherings. 

While someone with recurrent migraines likely won’t be able to get rid of them entirely, there are  many ways you can manage symptoms, including medical treatment, regular movement, and everyday habits that support your overall health.

Below, learn why migraine is more common in women, how hormones may affect your symptoms, and what can help at different stages of life.

Why does migraine affect women more often?

Migraine affects women much more often than men, with research suggesting migraine affects about one in five women and one in fourteen men. Hormonal fluctuations are a major contributor to this gender gap.

Estrogen interacts with your brain and nervous system in ways that may affect your migraine susceptibility. “Many women notice migraine patterns around times when estrogen levels are changing,” says Julia Guseva, PT, DPT, a Hinge Health physical therapist.

That can help explain why migraine often changes during puberty, around menstrual periods, during pregnancy, and throughout perimenopause and potentially after menopause.

Men aren’t affected by migraine nearly as often, and one explanation for that is because they don’t experience these major fluctuations in estrogen. Also, testosterone is known to be protective against migraine. In some men with migraine, low testosterone may be a contributing factor.

Hormones aren’t the whole story, though. Your genetics, nervous system sensitivity, stress, sleep, and other factors can all affect whether a migraine comes on and how often those attacks occur.

How migraine is different for women

Women don’t just experience migraines more frequently. Research suggests migraine may also place a greater burden on women overall. Compared with men, women with migraine may be more likely to experience:

• Longer-lasting attacks

• More frequent or disabling episodes

• Nausea and vomiting

• Greater sensitivity to light and sound

• A larger impact on work, daily activities, and quality of life

Of course, that doesn’t mean every woman will experience more severe migraines than every man. The severity of migraine varies widely from person to person, and even your own symptoms can change over time.

How hormones shape migraine through a woman’s life

Every woman’s hormonal journey is different, but women with migraine often experience similar milestones. Here’s a quick breakdown of the key events linked to changes in migraine susceptibility:

• Puberty and menstruation. Migraine often becomes more common in girls after puberty. Some women notice attacks before or during their period, when estrogen levels drop. These are sometimes called menstrual migraines.

• Pregnancy. Migraine patterns can shift during pregnancy. Some women, particularly those who have migraine without aura, notice fewer attacks as pregnancy progresses — but this isn’t the case for everyone. Some people experience migraine for the first time during pregnancy, while others notice new or different symptoms. Changes in hormone levels can trigger migraine for some people, too. If you develop a new or changing headache during pregnancy, talk with your healthcare provider.

• Postpartum and breastfeeding. Hormone levels shift rapidly after delivery, which can affect migraine. Sleep disruption, stress, dehydration, and changes in routine can also play a role during this period.

• Perimenopause. Migraine may become less predictable during perimenopause because estrogen levels can fluctuate significantly. Some women notice more frequent or intense attacks during this transition, while others don’t.

• Menopause. For many women, migraine becomes less frequent after they reach menopause once hormone levels stabilize, particularly if attacks were closely tied to their menstrual cycle. But migraine doesn’t necessarily disappear completely.

Tracking your migraine symptoms over time can help you and your healthcare provider understand how hormones may be affecting your migraine.

What helps migraine in women?

Migraine treatment often combines strategies for easing an attack when it happens with approaches that may help reduce how often attacks occur. Here are a few effective ways to manage and prevent migraine: 

• Treat attacks early. Several prescription medications can help stop or reduce migraine symptoms once an attack begins. Your healthcare provider can help determine which option is appropriate for you and when to take it.

• Consider taking an over-the-counter medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), acetaminophen (Tylenol), or Excedrin may help ease migraine pain. If you have a medical condition or take other medications, check with your healthcare provider about which option is right for you and how often to take it. Using over-the-counter headache medication too often — often 10 to 15 or more days a month, depending on the medication — can lead to medication-overuse (rebound) headaches.

• Talk to your provider about hormone-related patterns. If migraine regularly occurs around your period or changes during perimenopause, tell your healthcare provider. Your migraine history — including whether you experience aura — can be important when discussing hormonal contraception or menopause treatments, such as hormone replacement therapy (HRT).

• Keep your daily habits as consistent as possible. Regular sleep, meals, hydration, and stress management can help reduce common migraine triggers. “It can also help to pay attention to your stimulation levels,” says Dr. Guseva. “If you’re feeling more sensitive, a calmer environment with less background noise may feel better.”

• Keep moving, gently and consistently. Regular physical activity can support sleep, mood, stress management, and overall health, all of which may influence migraine. Dr. Guseva recommends building gradually, especially if intense exercise has triggered symptoms for you in the past.

• Track your patterns. Logging migraine attacks alongside your menstrual cycle, sleep, exercise, meals, hydration, stress, and medications can help you and your healthcare provider recognize patterns. The goal isn’t to control every possible trigger, but to better understand what may be influencing your symptoms.

• Try complementary treatments. Consider complementary treatments. Some people find approaches such as massage, acupuncture, or mindfulness helpful alongside their usual care. Talk with your healthcare provider before starting supplements or other treatments, since they aren’t appropriate for everyone.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain associated with migraine. One option is the wearable device Enso for Migraine, available through Hinge Health. It’s small, wireless, and portable.

When to see a doctor

Migraine is a common condition, but new or changing headache symptoms are always worth discussing with a healthcare provider or another member of your care team. Seek emergency medical care if you develop:

• A sudden, extremely severe headache that reaches peak intensity within a minute

• New weakness or numbness, especially on one side of your body

• New difficulty speaking, seeing, walking, or staying balanced

• A severe headache with fever and significant neck stiffness

• Confusion, loss of consciousness, or other sudden neurological changes

Some migraine symptoms, particularly aura, can overlap with symptoms of stroke or other neurological conditions. If a symptom is new or very different from your usual migraine pattern, seek prompt medical evaluation. Generally, it’s a good idea to make an appointment with your healthcare provider if you have:

• A new type of headache

• A change in your usual migraine pattern

• Headaches that are becoming more frequent or severe

• Migraine that regularly interferes with work, sleep, exercise, or daily activities

• Questions about migraine and hormonal contraception, pregnancy, or menopause treatment

PT tip: Use breathing to build in recovery

You can’t eliminate every source of stress, but you can give your nervous system opportunities to regulate throughout the day.

“Guided breathing or meditation can help you build decompression time into your day,” says Dr. Guseva. “That can help you manage stress and your overall energy levels, especially if you tend to overdo it when you’re feeling good.”

Try a few minutes of slow, comfortable breathing during a break, before bed, or whenever you notice yourself feeling overstimulated. It doesn’t have to be a long practice to count.

How Hinge Health can help you

If migraine is affecting your quality of life, you can get the relief you’ve been looking for with access to migraine care, virtual physical therapy, and more with Hinge Health. 

We offer a comprehensive program that helps you manage symptoms and delivers rapid relief of migraine pain in minutes with Enso for Migraine, an FDA-cleared wearable pain relief device. You’ll also have access to therapeutic exercises that help relieve migraine pain and personalized support from our care team designed to help you feel more in control of your symptoms. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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