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By Jana Bounds
It might seem a generalization, but it’s one based on studies: men are notoriously resistant to facing health issues, with many choosing the path of avoidance.
Studies show that men are twice as likely to wait longer than two years between doctor visits.
Whatever the reason, greater than 40% of men refuse to go to the doctor unless backed into corner by a serious issue.
Still, there’s hope for them getting help: “It turns out almost 20% of men admit to going to the doctor just so a loved one will stop bothering them about it,” according to Tri-City Medical Center.
So, while nagging is often counterproductive, at least in this case, it can help improve or even save a life.
June is Men’s Health Month and Migraine Awareness Month, and we want to discuss the stigma around men and migraines (and head pain, and trauma in general), why masculinity proves a barrier to quality medical care, how migraines are particularly dangerous for men, the current research, symptoms men should look out for, and what can be done.
Men with Migraines, Unnoticed and Underreported
Do a general Google search of “migraines” and you’ll get result after result focused on it being a “woman’s condition.” It’s true that women are statistically three times more likely to have migraine.
However, with all that focused marketing, all the stories that zero-in on women, the migraineur men in the world – nearly 10 percent of the world population—are forgotten; ignored.
Men who have migraine have been suffering without much acknowledgement: not in migraine medication commercials, not in magazine articles, and not even in scientific studies. Education, support, and branding have been focused on everyone BUT them.
However, times are changing: The medical community is beginning to close this gap in migraine research, and as a result of enhanced focus and greater understanding, researchers are saying that migraines in males are underreported, although the theories as to why are varied.
Men, Migraine, and Misunderstandings
“Men with migraine are stigmatized because they have a woman's, quote unquote, disorder,” Dr. Michael Oshinsky said. “That is probably at least one of the reasons why they're not reaching out for treatment.”
It is a problem that was recognized for the European Migraine Day of Action by the European Headache Alliance back in 2014. Noted in the review “Migraine in men: fact sheet” published in the National Library of Medicine, men tend to seek medical care for migraines far less frequently than women and more than half of migraineur men overuse pain killers in self-treatment. According to one survey, men are twice as likely to seek help for a backache or for insomnia than they are for a migraine or head pain.
It seems gender proves a barrier for men even in attaining a correct diagnosis of migraine, exacerbated by notably few men seeking medical assistance for it.
“Although part of the problem is that migraine attacks in women are more disabling, a bigger part is sociocultural. Men may fall less readily into the “sick role” (seeing it as a sign of weakness), and in some cultures this role is indeed less acceptable for men. Furthermore, it cannot be excluded that organizational barriers such as the lack of male-friendly health services might play an important role,” according to the paper.
Men need to understand that migraine is a brain/neurological disorder—a serious one at that –and the condition can have long term effects on quality of life. Further, their symptoms may differ from their female counterparts, which may contribute to the lack of proper diagnosis.
“Nausea and muscle aches are common, and many sufferers also experience a watering eye, a running nose, or congestion. A migraine episode may last from four to 24 hours,” according to Harvard. “Migraines tend to occur in the evening or at night and often come with warning signs, such as changes in mood, appetite, and activity levels.”
“I think there's actually a lot of misunderstanding of what migraine is, even within the medical community,” says Dr. Niushen Zhang, chief of the headache division at Stanford University’s Department of Neurology. “We think of it as sort of an invisible disease.”
Men Have Been Hesitant to Complain: A Culture of Pain Without Acknowledgement
“In many cultures, men need to be seen as strong. To avoid showing weakness, men may neglect signs of aches or pains and carry on,” according to Verywell Mind.
This is particularly evident in professional contact sports like the National Football League (NFL), where players are akin to gladiators in a modern coliseum, enduring incredible pain and risking their bodies for a game that generates billions of dollars in revenue annually.
While professional football is blatantly dangerous, the continuing struggles of former players are beginning to surface. With the “if you can walk, you can play” mindset, many players continued to charge and tackle through repeated traumas.
The NFL's history of head injuries and concussions has gained attention in recent years thanks to a class-action lawsuit, with former players experiencing lasting impacts, including migraines. However, the case was settled, meaning the public and players will be kept in the dark regarding what the NFL knew, and when they knew, about the hazards of brain injuries in the game.
The Migraine Reality of the Warrior Mentality
Former NFL players, such as Hall of Fame quarterback Troy Aikman and former Los Angeles Rams defensive back Leroy Irvin who maintains the record for the most punt return yards in a single NFL game, have spoken about their experiences with migraines. Their stories shed light on the hidden burden of migraines among athletes and the pressure to downplay the issue. Similar issues arise among soldiers returning from war, where migraines are prevalent but often go unaddressed due to the "warrior mindset."
An evaluation of retired NFL players in a study conducted by Dr. Frank Conidi, director of the Florida Center for Headache & Sports Neurology in Port St. Lucie, Fla. found a link between concussions and migraines. Researchers discovered that the former players averaged more than 19 headache days per month, with twelve of those 19 days involving migraines.
As Aikman told WebMD about his migraines: “When you make a living getting hit, almost everyone has a headache, so it’s not something that’s much talked about.”
Leroy Irvin and Tom Newberry: The 80's NFL Experience
Irvin, who played 11 NFL seasons, told Health by Principle (HBP) he has yet to receive any compensation from the concussion lawsuit. Although he’s left wondering why he hasn’t received any funds, he also notes it’s not about the money.
Irvin said they were required to make incredibly violent, high impact tackles for job security within the NFL. It’s how training was done: play hard, put your body on the line, or go home.
“I’m glad we changed the game,” he said regarding the NFL rules changes for player safety that took place after the lawsuit. “I’m happy we did it because now we can spare these young kids coming up, so they don’t have to live lives of misery.”
Irvin and former offensive guard Tom Newberry, who spent nine seasons with the Los Angeles Rams and one with the Pittsburgh Steelers (where he was a starter in Super Bowl XXX) told HBP that the impacts of repeated concussions have haunted them and their former teammates and friends.
They point to Chronic Traumatic Encephalopathy (CTE), a progressive and fatal brain disease prompted by repeated head trauma. The struggles are myriad, and the disease is known to cause crippling depression, early dementia, behavior changes, and lasting pain from nerves that have been killed off.
Years ago, an NFL physician told Newberry he has CTE –he could tell by Newberry’s gait, although right now a formal diagnosis can only occur postmortem.
Newberry and Irvin are electing to donate their brains to science, even just to further confirm findings from one recent autopsy study, which showed that over 90% of former NFL players’ brains exhibited CTE.
Irvin says he knows to his core he has CTE and he also has “headaches and migraines, the whole nine yards.” His head starts throbbing at least once a week and he has to go to sleep to get relief of any kind. Although he hates taking pain medications, he usually takes aspirin because his pain is so excruciating.
Some of their past competitors and friends were so desperately unhappy from the impacts of CTE on their lives that they died by suicide, while being careful to not damage their brains—so they could be analyzed for the CTE study.
Other Groups of Men Affected by Migraine
Migraines aren’t just common with professional athletes, but also with soldiers returning from war.
Studies show that 36% of veterans who completed a year-long deployment to Iraq either exhibited symptoms of migraine or were diagnosed with them.
The staggering numbers of former NFL players and soldiers currently struggling has helped open the door to more focus on headache and migraine research.
“There’s been an explosion of interest in concussion and traumatic brain injury in big, strong men in the military and in football,” Dr. Gottshalk, MD, FAHS, the Director of Headache Medicine at Yale’s Neurology department told Verywell Mind, explaining migraine is one of the most common problems for guys returning from war.
Professional Athletes and Celebrities Share their Struggles to Shatter the Stigma
The shift is occurring, and it’s prompted by retired pro athletes like Newberry and Irvin, current pro athletes, and celebrities who are willing to share their stories.
Together, they are chipping away at the stigma around head trauma, pain, and migraine.
Ben Affleck was rushed to the hospital with a migraine when he was in the middle of directing “Gone, Baby, Gone”. He has been suffering from chronic migraine for years and was roasted online for sleeping so much during his 2022 honeymoon with Jennifer Lopez, but his exhaustion was due to his migraine condition, according to WebMD.
Denver Bronco Terrell Davis was temporarily sidelined during the 1998 Super Bowl by migraine, noting he was seeing double and triple. He remained silent about his migraine condition for years because he “thought people would think I was crazy,” he also told WebMD.
Increased Risk of Other Health Issues for Men
Migraine often eludes diagnosis, despite being the most common cause of disability in people under the age of 50. Of the 36 million people in America who experience migraine, only around 12 percent are correctly diagnosed, according to UK GQ.
Men who have migraines are significantly more likely to suffer a stroke or cardiac event, with one Harvard study showing a 42% increased risk for heart attack. Other research from Loyola University system cited by Harvard suggests that those who suffer migraines are at double the risk of suffering an ischemic stroke caused by a blood clot.
Additionally, people who suffer migraines with aura are at an even higher risk of heart attack, according to Harvard, and those who get migraines are also 50% more likely to have key risk factors for heart disease like diabetes, high blood pressure and high cholesterol, as noted by a study in the journal Neurology, cited by Harvard.
Magnesium for Migraines
A large body of literature suggests a relationship between magnesium deficiency and mild and moderate tension-type headaches and migraines.
“Magnesium for headaches offers an alternative to traditional medication that brings with it issues, such as addiction and side effects. Magnesium, with its relative lack of side effects, is particularly compelling for use in groups in which side effects are less well tolerated, such as children, pregnant women and the elderly population,” according to the study. Whereas the use of oral magnesium salt is often a well-tolerated and inexpensive addition in the treatment of headache patients that can reduce the frequency of attacks “both in terms of economic burden and adverse events.”
Also noted in the study: magnesium homeostasis in the brain has been found to be dysregulated in various neurological disorders, including lower concentrations of magnesium than in healthy controls in the brains of patients with Alzheimer’s and Parkinson’s diseases and in the occipital lobes of patients with migraine and cluster headaches.
Study results suggest a correlation between magnesium deficiency and headaches, and most notably, “they suggest that magnesium deficiency represents an independent risk factor for migraine occurrence.”
Additionally, men are only consuming about 80% of the recommended amount of magnesium per day.
“We’re just barely getting by,” Dana King, M.D., a professor of family medicine at the Medical University of South Carolina told Men’s Health. “Without enough magnesium, every cell in your body has to struggle to generate energy.”
Mitigate the Mystery
Research continues, delving into the mysteries of the brain, and with continued focus on migraines, and their prevalence in males, particularly those who have experienced any kind of trauma from contact sports or military service. Experts are arguing that repeated brain trauma from youth contact sports can also have serious implications much later in life.
As part of Men’s Health Awareness Month, we encourage anyone who is struggling with symptoms of CTE or migraine (or any health concern at all) to please take the necessary steps to understand what’s going on and seek the appropriate treatment. Now is the time to take charge of your medical issues – to fight for your health.
