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Migraine in Men in Elizabethan Times
Migraine in men was seemingly taken a lot more seriously way back when…
In her book, ‘Migraine, A History’, (Johns Hopkins University Press) historian Katherine Foxhall mentions an Elizabethan gentleman, Francis Thomson who is “…much troubled so by the mygrame & sciatica in my hypp.”
He was writing this in a letter to “Sir Michael Hickes, the secretary to Lord Burghley, Queen Elizabeth I’s lord treasurer”. He was looking to keep out of the way of a particularly dangerous religious reformer, Richard Topcliffe, known for his torment of Catholics during the reign of Elizabeth I. Thomson was a recusant who refused to change from Catholicism and hoped that telling Sir Michael about his “mygrame and sciatica” might help to make his case for him.
He wanted to travel to a town called Buxton in Derbyshire, where St. Anne’s Well was said to have had healing properties. St. Anne’s Well had been visited by Mary Queen of Scots several times previously. However, during Elizabeth I’s reign, this was quite a risk. Many such sites were closed down by reformers such as the man he was trying to avoid.[1]
Unfortunately, the author was unable to find out whether Mr. Thomson made it to the well, but the fact that he was desperate enough to risk it shows that back in Elizabethan times, some men were willing to risk a lot to help them with migraine.
Present time
Unfortunately, the ‘Hollywood’ version of man as the ‘strong, silent warrior who sneers at death and laughs at pain’, has contributed to the idea worldwide that for a man to complain or seek help for illness marks him as weak, or pathetic.
Surely fighting your own demons marks you as the bravest of all warriors! – just my opinion!
As many of our male members know, migraine does occur in men. Though it is three times more common in women, an estimated “12% of men in Europe between 18 and 65 years of age are regular migraineurs. (That’s over 400,000 men in Ireland alone!) Almost 1% of men suffer a chronic form of migraine. These men experience an attack on more than 15 days per month and half of them overuse pain killers”[2].
The misconception that migraine is a female only condition can cause men to avoid seeking medical support. Many dismiss this debilitating neurological condition as just a headache. This often leads to men self medicating with over the counter medications. In turn this can lead to developing Medication Overuse Headache, which is a huge problem among Irish men today.
According to an article by the late, great Paolo Rossi in 2014 “Gender plays a role in how headache is experienced, treated and coped with. Men more often cope with their headaches without any medical support, simply “dealing with pain when they have to...”
“…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.”[3]
Paolo was a brilliant advocate for those suffering from Cluster Headache, which does occur more often in men than in women. He understood the importance of taking patients seriously when they present with these invisible illnesses.
Some Irish Stats on Healthcare Engagements
Men are just as concerned and interested in their health as women are, however the statistics do not give that impression.
“Across the broad range of visits to health professionals, females are more likely to visit than men. 82% of females reported that they visited a GP in the 12 months prior to survey, compared to 68% of men. 63% of females visited a dentist compared to 52% of men. As regards visits to GPs, older people report visiting them more than younger people (94% of 75 years and over compared to 67% of 15 – 24-year-olds)[4] ”
According to the Men’s Health in Numbers Report by the Men’s Health Forum in Ireland “Explanations for the lower rates of help seeking behaviours among males include masculine norms, attitudes and behaviour, perception of the severity of the health problem, engagement in risky behaviours, and lack of health-related knowledge.” This ties in with the previously mentioned paper by Dr. Paolo Rossi.
Differences between Migraine in Men and Women
Migraine itself is not any different in men than women, however, one study[5] showed that compared to women, men:
- were slightly older at onset of their headaches.
- had fewer headache days per month.
- experienced slightly less severe attacks.
- had reduced frequencies of grade IV Migraine Disability Assessment scores (MIDAS).
Men were also less likely to report speaking to a doctor about their headaches and receive a migraine diagnosis if they did so.
The study “confirmed gender differences. Men with migraine generally have less severe attacks and disability and are less likely to receive a diagnosis than women with migraine. Prognostic factors may be better understood for women than men”.
Other differences
For one, men generally don’t have the hormonal triggers women have, and this is probably the reason that migraine is less prevalent in men. However, other triggers such as Stress, Anxiety, Exercise, Alcohol consumption are all culprits in triggering migraine in men.
Stress and Anxiety
Stress is a common trigger for migraine among men and women. Women though are traditionally better at seeking help with stress and anxiety. They sign up to stress reduction classes, such as yoga or mediation, more readily than men.
It’s important also to recognise that stress is a medically proven trigger and not some “excuse” or unfounded cause.
See the graph below.
Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007; 27:394–402. London. ISSN 0333-1024
The above study concluded that “Three-quarters of migraineurs have triggers at least occasionally for the acute attack, with stress, hormones in women, not eating, weather and sleep disturbance being the commonest.”[6]
In 2017 researchers from the Massachusetts General Hospital in Boston wanted to see whether they could design a way to more accurately predict when a migraine would strike. The study[7] found that, stress was more likely to be greater in the days leading up to a headache and the results point to stress as a trigger for many migraine sufferers.
More and more men are taking part in yoga and meditation classes or are taking time to visit a therapist who specialises in stress reduction techniques, mindfulness, etc. For examples see our Online Programme Videos
Something like Yoga, can really help migraineurs in several ways. According to a study from the International Journal of Yoga[8] “Yoga as an add-on therapy in migraine is superior to medical therapy alone. It may be useful to integrate a cost-effective and safe intervention like yoga into the management of migraine.”
Yoga can also help to decrease stress levels, relieve anxiety, improve heart health, quality of life, improve breathing, strength, flexibility and balance.
Exercise Induced Migraines
High impact sports and prolonged periods of exertion often trigger migraine in men. Re-hydration and regular eating before sports matches or tournaments can help prevent attacks. If possible, avoid exercise in high heat and humidity – relatively easy to do with Ireland’s weather!
Many men find the gym a triggering environment for migraine so switch up your exercise routine to an outside class and if you feel an attack coming or take the easy option of a walk that day and avoid worsening the condition with vigorous movement and exercise.
Talk to your sports coach or trainer and explain the situation so they allow you to take a break when needed.
The Migraine Association can speak to your sports club or gym to provide an information session on migraine, so coaches and staff understand the condition.
Don’t give up on exercise though as it is important in the long-term prevention of migraines. Find a form of exercise that works for you. One study has found that “there is moderate quality evidence that in patients with migraine aerobic exercise therapy can decrease the number of migraine days”[9]
See our website for more information on Migraine and Exercise
Supplement Intake
If you are eating a healthy diet and still experiencing regular migraine attacks, then you might consider taking a supplement.
Magnesium plays a major role in the effective functioning of the body’s neurological system. Many Migraineurs find that taking 400 -500 mg of magnesium a day can be effective for preventing migraine.[10]
Other supplements include Riboflavin or Co Enzyme Q10 can also act as a preventative treatment.
Make sure you speak to your GP or pharmacist first, especially if you are suffering from other conditions. Supplements can interact with some medication.
Alcohol Intake
Alcohol and certain types of alcohol can have a triggering effect for some people.
Migraineurs seem to be able to tolerate white wines, stouts and spirits better than red wines and beers. However it’s often the regularity and amount of alcohol consumed that contributes to an unhealthy lifestyle and triggers migraine. Therefore, reducing the amount of alcohol and changing your tipple of choice may allow you to enjoy alcohol and keep migraine at bay.
If you would like to find out more about why red wines are more triggering for migraineurs than other types of alcohol, this article gives some good information.
What else can I do?
Well, a few years ago, the Men’s Health Forum in Ireland created the ‘Haynes Man Manual’! Written by Dr. Ian Banks, president of the European Men’s Health Forum, it’s a fantastic guide for the men of Ireland to read, challenge themselves and look at their choices to see how they contribute to their health.
It includes sections on Alcohol, Food, Physical Activity, Blood Pressure, Stress, and Smoking. Each with tips, challenges and three choices laid out for the reader. There are also several facts about the issues in each section and lots of very helpful advice.
The Men’s Health Forum in Ireland also have a great website with lots of information and resources on it.
MaleHealth.ie is a men’s health resource from the Irish Men’s Sheds Association another fantastic organisation that can be very helpful to men who need help. They define a ‘men’s shed’ as “a community-based project, where men can come together to learn, share skills and make long-lasting friendships together.” MaleHealth.ie is a site they offer for men to “discover more about your health and wellbeing and gain a better understanding of health issues common to your age group”.
You can also contact us here at MAI via email at info@migraine.ie where we can give you information and try to put you in touch with experts who can help you.
The information above is for information only and not intended to replace medical advice or diagnosis. Please see your doctor or pharmacist for medical information or advice.
References
[1] Foxhall K. Migraine: A History Baltimore (MD): Johns Hopkins University Press; 2019. ISBN-10 : 1421429489 ISBN-13 : 978-1421429489
[2] Lanteri-Minet M. Economic burden and costs of chronic migraine. Curr Pain Headache Rep. 2014;18:385–391.
[3] Migraine in men: fact sheet. A publication to mark European Migraine Day of Action 2014 Paolo Rossi, MD, PhDa,b,1 and Giuseppe Nappi, MDc
[4] Irish Health Survey 2019 https://www.cso.ie/en/releasesandpublications/ep/p-ihsmr/irishhealthsurvey2019-mainresults/engagementwiththehealthsystem/
[5] Epidemiology of migraine in men: Results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study Ann I Scher 1, Shuu-Jiun Wang 2 3, Zaza Katsarava 4, Dawn C Buse 5 6, Kristina M Fanning 7, Aubrey Manack Adams 8, Richard B Lipton 5 6 9
[6] Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007; 27:394–402. London. ISSN 0333-1024
[7] Forecasting Individual Headache Attacks Using Perceived Stress: Development of a Multivariable Prediction Model for Persons With Episodic Migraine Timothy T. Houle PhD Dana P. Turner PhD, MSPH Adrienne N. Golding BA John A. H. Porter MD Vincent T. Martin MD Donald B. Penzien PhD Charles H. Tegeler MD
[8] Effect of yoga as add-on therapy in migraine (CONTAIN) A randomized clinical trial Anand Kumar, Rohit Bhatia, Gautam Sharma, Dhanlika Dhanlika, Sreenivas Vishnubhatla, Rajesh Kumar Singh, Deepa Dash, Manjari Tripathi, M.V. Padma Srivastava
[9] The effect of aerobic exercise on the number of migraine days, duration and pain intensity in migraine: a systematic literature review and meta-analysis Joris Lemmens, Joke De Pauw, Timia Van Soom, Sarah Michiels, Jan Versijpt, Eric van Breda, René Castien & Willem De Hertogh The Journal of Headache and Pain
[10] https://headachejournal.onlinelibrary.wiley.com/doi/epdf/10.1111/head.12220 Tepper, Stewart
