Why Men’s Migraines Often Go Undiagnosed for Years: Key Insights

Migraine is still considered a typical female ailment. However, many men are affected—and they may not even know it. A neurologist explains why migraine is often not recognized in men and which symptoms should be taken seriously.

“About five to ten percent of men are affected,” says Assistant Professor Dr. Bianca Raffaelli, senior physician and head of the headache center at Charité in Berlin. “The actual number is likely higher since men less frequently seek medical help for headaches.”

Migraine Often Remains Undetected in Men

Many people associate migraine with severe headaches, light sensitivity, and nausea. Affected individuals may need to withdraw to a dark, quiet room during an attack. However, in men, migraine often presents in a less typical manner, leading to delayed or even missed diagnoses, according to the neurologist.

“Men frequently experience less pronounced accompanying symptoms such as nausea or sensitivity to light and sound,” says the doctor. Moreover, migraine attacks in men tend to be shorter than in women, which can last between four and 72 hours. “Men typically report a lower intensity of pain as well.”

This results in migraine being overlooked more often in men. Additionally, not only do many individuals mistakenly believe that migraine primarily affects women, but some healthcare professionals do as well. “Consequently, other diagnoses are often sought for men,” she says.

Signs Indicating Migraine

Even if symptoms in men are sometimes less pronounced, there are typical indicators of migraine. “Typically, one-sided, pounding, or sharp pains that worsen with physical activity and last several hours to three days are characteristic,” notes Raffaelli.

Men can also experience light and sound sensitivity or nausea along with their headaches, although these may be less severe than in women. With migraine with aura, additional neurological symptoms may occur before or during headache phases. These can include visual disturbances, sensory changes, or speech impairments that resolve on their own.

“When such patterns recur, migraine should be specifically investigated rather than simply classifying the discomfort as stress- or tension-type headaches,” advises the neurologist.

If migraine remains untreated for years, the condition can worsen: for some individuals, it can become chronic. Medical professionals define chronic migraine as experiencing headaches on at least 15 days per month, with migraine occurring on at least eight of those days.

When Men Should See a Doctor for Headaches

However, many men wait a long time before seeking treatment for their headaches. Common pain relievers often do not work effectively for migraine. Additionally, individuals experiencing frequent headaches may resort to numerous medications, which can increase the risk of making migraine chronic over time.

“Men should seek medical advice at the latest when headaches recur and affect quality of life, performance, or daily activities,” says the neurologist. Moreover, if headaches become more frequent or regular pain relievers are ineffective, consulting a doctor is advisable.

Available Treatment Options

Today, migraine can be treated significantly better than in previous years. However, early diagnosis is crucial. “In acute treatments, classic pain relievers are first used, and for more severe symptoms, specific migraine medications such as triptans are employed,” says Raffaelli. The goal is to stop an attack as early as possible.

Preventive measures are also available: Regular exercise, relaxation techniques, consistent sleeping patterns, and a regular daily rhythm have proven beneficial for many individuals to avoid attacks. In cases of frequent or severe attacks, preventive medications may also be administered to reduce both frequency and severity.

Maintaining certain regularities in daily life is also sensible, as stress, lack of sleep, irregular meals, and alcohol can trigger attacks. The neurologist clarifies that while these factors can initiate attacks, they are never the underlying cause of the condition.

Migraine is a neurobiological condition with a genetic basis,” she explains. “Lifestyle factors can influence when and how often individual attacks occur, but they do not determine whether someone has migraine in the first place.”

Taking Headaches Seriously

For men experiencing frequent or severe headaches, the neurologist offers clear advice: “Men with regular, strong headaches should initially consult their general practitioner and describe their symptoms comprehensively, including frequency, duration, pain characteristics, and accompanying symptoms.”

If the diagnosis remains unclear or treatments are insufficient, it may be beneficial to have neurological assessments performed. The key takeaway is, “To take headaches seriously and not to ignore them for years.”