Why do women get more migraines than men? Researchers have a few clues.
Not only do women get more migraines than men, but a new study shows they also experience them for a longer duration.
One fact that makes a girl’s head hurt: Adult women are three times more likely to get migraines than men. And now, a global 2025 study has found women also spend more time suffering from migraines overall.
Published in The Lancet Neurology in December, the study analyzed headache data from 41,000 male and female patients across 18 countries. While previous headache papers demonstrate women experience migraines more often, researchers wanted to understand if women also suffer longer.
“Prevalence in itself doesn't actually provide that much information,” says Andreas Kattem Husøy, one of the lead study authors and a postdoctoral fellow at the Norwegian Center for Headache Research. “You also need to know how the disease affects individuals.”
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The study authors took patients’ survey data where they logged their typical migraine duration and frequency, analyzing for the first time how long migraines last based on a person’s age or gender. The results show that the amount of time women suffer migraines is nearly double compared to men.
Coupled with the fact that women get migraines more often, the Lancet study concludes “females have more than twice the burden of males.”
But what’s behind the gender disparity? We spoke with neurologists about the current theories.
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What is a migraine—and what triggers one?
Although a common misconception, “migraine is not just a headache,” says Messoud Ashina, director of the human migraine research unit at the Danish Headache Center. During a migraine attack, many people experience nausea, vomiting, fatigue, or become sensitive to lights and smells.
The exact biological mechanisms causing migraines are unknown. Current research suggests migraines occur in the trigeminovascular system, a network that encompasses nerves, brain cells, and blood vessels in the brain. Researchers believe when blood vessels in the trigeminovascular dilate, head pain occurs.
What triggers a migraine can vary: genetics, poor diet, a bad night’s sleep, or hormones are all factors. Some patients also rely on headache medication, both over-the-counter and prescription, too much, which can lead to unnecessary headaches called medication overuse headache, according to Husøy’s study. About 20 percent of headache burden could be avoided if people medicated correctly, the study concludes.
(What triggers morning migraines? Scientists might now know.)
But hormones might be why women spend more time suffering from migraines, according to Addie Peretz, a neurologist and headache specialist at Stanford University who was not involved with the study. Decades of research imply hormones play a role in how migraines affect women. Receptors for female hormones estrogen and progesterone are found in the trigeminovascular system, further suggesting a potential hormonal link.
The fact that women may spend more time with migraines than men does not surprise Peretz. “We know… it probably is partly hormonally-driven,” she says. Experts have a few theories about why.
The estrogen withdrawal theory
The estrogen withdrawal theory dates back to 1972. Neurologist Brian Somerville, compelled by a 1666 account of a noblewoman experiencing migraines during her period, conducted a small study that suggested migraines are triggered when levels of estrogen—a key hormone that regulates the menstrual cycle—drop in the body.
Since then, multiple neurologists set out to investigate more. One popular 1962 study surveyed boys and girls about migraines. The study found that before the age of 10, both genders experienced about the same number of migraines. But after that age, girls’ risk jumped significantly. Other recent studies appear to find similar links between puberty and migraine.
In other words, “your period begins. And that seems to be a potent trigger for migraine,” Peretz says. “When an individual is menstruating, there is a monthly cyclic fluctuation in estrogen dosing. The estrogen falls in the late-luteal phase of the menstrual cycle” right before menstruation begins.
Interestingly, several studies suggest a woman’s life stage may also influence migraine frequency due to differing estrogen levels. For example, pregnant women seem to be relieved from migraine symptoms in their second or third trimesters, when estrogen levels are normally high.
Conversely, during the months or years before menopause known as perimenopause—roughly in a woman’s mid- to late-40s—estrogen levels rise and fall erratically. “During that time, migraine can significantly worsen,” Peretz says.
(What is perimenopause? Your brain may hold a clue.)
Still, estrogen fluctuation only partially explains migraine triggers, Ashina says. A large number of women experience headaches outside of the menstrual cycle, and millions of men also deal with them. Ashina co-authored a 2023 paper that notes research supporting this estrogen withdrawal hypothesis, while plausible and widely accepted, also relies on limited studies.
“[Somerville’s] small study was conducted in six people back in the ‘70s,” Ashina says. “So the evidence there still needs to be refined.”
Ashina’s team is currently investigating the molecular mechanisms behind migraines and eventually plans on studying these in women. “I think that there are so many things [happening] in the human body during this process,” Ashina says. “There could be different molecules involved in this case.”
The need for women-centered research
Despite clear data that migraines are more common in women, there are not enough studies that focus on how migraine affects women specifically, authors of a 2025 paper argue.
In the past, women with migraines were stigmatized. Former chief neurologist at Cornell Medical Center Dr. Harold G. Wolff, who is considered “the father of modern headache research,” diagnosed migraine differently in women and men, according to a 2024 migraine stigma analysis. Wolff interpreted migraines in women as a “psychological issue,” which led to stereotypes that women’s brains were “fragile.” This caused female migraine patients to be taken less seriously.
That mindset has had long-lasting impacts, leading to women’s health being an understudied and underfunded issue today.
This can translate to unequal burden, says Husøy. Headache disorders are the sixth most disabling conditions worldwide, and migraines are also one of the top reasons people miss work. But for women, migraines often spike at an age when career and raising family is at its peak. Migraine prevalence is highest forboth genders in their 30s, Husøy says; additionally, when women begin perimenopause in their 40s, migraines worsen.
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The best way to combat disproportionate suffering is through research. Husøy hopes to build upon his recent study’s findings and explore the different impact migraine has on men versus women.
Research can also lead to better therapies for women. Suchitra Joshi, an associate professor of neurology at the University of Virginia Brain Institute, published a 2025 study focusing on how the hormone progesterone, which regulates the menstrual cycle and is produced in the first few months of pregnancy, may impact migraine. The study found that by turning on progesterone receptors in female mice, they became more sensitive to migraine-associated symptoms; alternatively, blocking the receptor suppressed the symptoms.
Although we can’t draw conclusive comparisons between mice studies and humans, “we believe that understanding this role of these important female hormones will definitely deepen our understanding of the pathophysiology,” Joshi says.
Migraine is undoubtedly a debilitating condition. “Women in their prime are more at risk of having a hormonal impact,” she says. By understanding what causes migraines, specifically in women, “we can potentially identify targeted therapies.”
