Men have migraines too.
Migraine is rightfully considered a women’s health issue since of the more than 39 million Americans with migraines, 28 million are women. But 11 million is still a lot of men. Unfortunately, men do not seek help as often as women do and we see this in our office and in clinical trials of new drugs for migraines, where the ratio is closer to 1 to 10.
The article notes that men are notoriously bad patients. In our office, it is usually a mother, a wife, or a girlfriend who brings the man to the office. Men consider complaining of a headache or any other symptom a sign of weakness. They just grin and bear until they are totally incapacitated. This is probably one of the reasons why women live longer.
Fortunately, migraines are not life-threatening but they can certainly ruin relationships, affect job performance, cause depression and other problems. Men are often reluctant to share their feelings and see a therapist and have higher suicide rates than women.
Men tend to be not very compliant with treatment and are more likely to come in for Botox injections every 3 months rather than take a pill every day. In this case they are acting rationally since any oral medication has more potential side effects than Botox. Regular exercise, which is at the top of my list of preventive therapies, also tends to appeal to men, but my second recommendation, meditation much less so.
Men are more receptive to the idea of taking a shot for their problem and here they are also correct – taking an injection of sumatriptan (Imitrex) stops an attack of migraine within 10-20 minutes, while a pill of sumatriptan can take up to two hours and may not work as well.
The new class of CGRP monoclonal antibodies (Aimovig, Ajovy, Emgality) also obviates the need for taking a pill every day – they are injected once a month (Ajovy can be injected every three months) to prevent migraines.
The bottom line – if you know a man who admits to having headaches, chances are they are suffering more than they let on. Tell them to see a headache specialist.
I am glad you’ve found my blog useful. There are no studies to establish an effective dose of aspirin for the prevention of migraine headaches. A very large Framingham study showed that even 81 mg of aspirin prevents migraine attacks, but we don’t know if a higher dose is more effective. While aspirin has other benefits as well, including prevention of various cancers, its risks are not negligible. Bleeding stomach ulcers and other bleeding complications can be serious. These side effects are unpredictable – some people take 2,000 or 3,000 mg a day for years to treat their arthritis and have no side effects, while others develop a bleeding stomach ulcer from taking 81 mg a day. Follow your doctor’s advice and look out for stomach bleeding – sometimes there is no stomach pain, only your stool turns black.
First, thanks so much for this blog. It has been the MOST helpful site as my husband has failed treatment after treatment and suffered chronic migraine disorder after a 15 year career as a professional snowboarder. Currently he is temporarily not on an everyday treatment as he has just failed the last of the CGRP migraine drugs. He’s interested in trying daily Aspirin use. I’ve read a few studies and of course your blog and wonder if you could recommend a daily dosage. His primary care is on board also, but is the 1,000 mg too much if used as a preventive daily? Like I said, your blog has really been a lifesaver and helped us so much generate a new list of meds to ask our neurologist about and therapies like everyday meditation to add into daily life. You are giving hope to so many suffering that live too far away to access your headache center! Thanks from Idaho!