Sex/Gender Differences in Migraine: Exploring Pathophysiology, the Impact of Sex Hormones, and Tailored Therapeutic Approaches

Migraine is a neurological disorder characterized by severe disabling headaches with a substantial global burden and elevated morbidity rates. Extensive research has established a clear association between migraine and sex/gender, with a notably higher incidence reported in females, reaching up to 18%, which is three times greater compared to males. Additionally, women commonly experience more intense pain and greater frequency of migraine symptoms, both with and without aura, highlighting the differential impact of sex/gender on migraine presentation. This review comprehensively examines the pathophysiology of migraine, with a particular focus on the effects of sex hormones in migraine pathophysiology and the central nervous system. Furthermore, we explore various treatment modalities tailored to gender differences, including pharmacological interventions and emerging therapeutic approaches. Furthermore, we explored alternative treatment strategies such as nutraceuticals and behavioural techniques, including mindfulness and cognitive behavioural therapy. This review aims to provide a comprehensive overview of the multifaceted nature of migraine and the diverse therapeutic approaches available for their management.