While cluster headaches are more common in men than in women, a recent study reveals that the illness may be more severe in women. The findings will be published online in Neurology®, the American Academy of Neurology’s medical publication, on December 21, 2022.
Cluster headaches are brief but excruciatingly severe headaches that can occur multiple days or even weeks in succession. The headaches might last anywhere from 15 minutes and three hours.
“Cluster headache is still often misdiagnosed in women, perhaps because some aspects can be similar to migraine,” said study author Andrea C. Belin, PhD, of the Karolinska Institutet in Stockholm, Sweden. “It is important for physicians to be aware of how the disorder manifests differently in men and women so the most effective treatment can be given as fast as possible.”
Cluster headache is still often misdiagnosed in women, perhaps because some aspects can be similar to migraine. Physicians need to be aware of how the disorder manifests differently in men and women so the most effective treatment can be given as fast as possible.
Andrea C. Belin
The study included 874 patients with cluster headaches, including 66% men and 34% women. Participants filled out an extensive questionnaire on their symptoms, medications, headache triggers, and lifestyle choices.
Chronic cluster headaches were more commonly identified in women than in men. Chronic cluster headache is characterized as repeated cluster headache attacks for one year or more without interruption, or with brief intermissions with no symptoms lasting less than three months. Chronic cluster headache was diagnosed in 18% of women and 9% in males.
Attacks also lasted longer for women than for men. For example, 8% of women said headache bouts lasted an average of four to seven months, compared to 5% of men, while 26% of women said bouts on average lasted less than one month, compared to 30% of men.
Women were also 74% more likely than males to report having attacks at different times of day. Women were 15% to 7% more likely than men to have a family history of cluster headaches.
“While the ratio of men to women with cluster headache has been shifting over the years, it is still considered mainly a disorder of men, making it more difficult for women with milder symptoms to be diagnosed with cluster headache than men,” says Belin. “It’s possible this could contribute to the higher rate of chronic cluster headache in women.”
One weakness of the study was that the participants recounted the information, thus they may not have remembered everything accurately.
