18/01/2026
Why Is Migraine More Common in Women Than Men?
Analysis by Dr. Joseph Mercola December 18, 2025
STORY AT -A-GLANCE
Migraines affect women three to four times more often than men, largely due to
hormonal fluctuations that sensitize the brain’s pain pathways and increase vulnerability
to stress, poor sleep, and inflammation
Estrogen both primes and triggers migraine attacks — high levels heighten sensitivity,
while sudden drops before menstruation or after childbirth cause the electrical instability
that sparks pain
Natural progesterone helps counteract estrogen’s pro-inflammatory effects, calming
nerve excitability and reducing migraine frequency during hormonally active years
Mitochondrial dysfunction is a major driver of migraines; reducing linoleic acid from seed
oils and restoring nutrients like magnesium, CoQ10, and B vitamins strengthens your
brain’s energy supply and resilience
Supporting melatonin through morning sunlight, minimizing blue light exposure at night,
and maintaining oral and circadian health naturally lowers inflammation, helping prevent
migraines and improve overall brain function
Migraines aren’t just headaches — they’re a full-body storm that hijacks your senses,
drains your energy, and derails your day. The pain is often piercing or throbbing, but what
makes migraines especially disruptive is how they affect your thinking, mood, and ability
to function. Even ordinary things like light, sound, or certain smells often feel unbearable
during an attack.
For millions of women — who experience migraines three to four times more often than
men 1
— these episodes are recurring events that reshape daily life, work, and
relationships. Rather than being confined to one system of your body, migraines start in
your brain’s electrical and vascular networks and spread outward, involving nerves that
control sensation, vision, and balance.
Over time, frequent attacks exhaust your body’s energy supply, strain your stress
response, and interfere with sleep, setting up a cycle that’s hard to break.
Researchers are now discovering that this condition has as much to do with how your
brain handles energy and hormones as it does with pain itself. Differences in brain
wiring, cellular metabolism, and hormonal rhythms make women especially vulnerable,
but they also reveal clear pathways for prevention and healing. Understanding these
underlying drivers helps you see migraines not as random attacks but as signals from an
overtaxed system ready for repair.
Hormones Drive the Gender Gap in Migraines
Before puberty, boys and girls experience migraines at roughly the same rate, but as
estrogen levels rise and fluctuate through adolescence, the difference becomes
dramatic. An article published in The Conversation highlights that as many as 1 in 3
women live with migraines, compared to only 1 in 15 men — a disparity rooted in biology
rather than behavior.
2
• Migraine attacks are linked to specific phases of a woman’s life when hormones
swing the most — Women often notice that migraine episodes cluster around
predictable “milestone moments, ” such as puberty, menstruation, pregnancy, and
perimenopause. Each of these phases is marked by changes in estrogen. These
hormonal rollercoasters make the female brain more vulnerable to energy depletion,
sensory overload, and inflammation — all factors that intensify pain perception.
The late Dr. Ray Peat, a pioneer in bioenergetic medicine, long proposed that excess
estrogen plays a central role in triggering migraines — and modern research has
begun to validate that idea.
Research published in Frontiers in Molecular Biosciences found that estrogen
heightens the sensitivity of cells surrounding the trigeminal nerve — the major nerve
that controls facial sensation and pain — and nearby blood vessels, amplifying pain
signals that lead to migraine attacks.
3
Because estrogen peaks during a woman’s reproductive years, this also explains
why migraines are not only far more common in women but most prevalent during
this stage of life. The same research noted that progesterone appears to have a
protective effect. This makes sense if estrogen is causative, as natural
progesterone is an estrogen blocker.
• Fluctuating estrogen directly alters brain activity and pain signaling — Sudden
hormone drops also trigger a wave of abnormal electrical activity known as cortical
spreading depression — a slow electrical ripple that temporarily disables normal
brain function. 4
This wave helps explain why migraine symptoms go beyond head
pain and often involve dizziness, nausea, or sensitivity to light.
At the same time, when estrogen dips, the trigeminal nerve becomes
overstimulated, heightening sensitivity and causing the throbbing pain that defines
a migraine. This connection might seem like a contradiction: how can both a high
level and a sudden drop in estrogen cause trouble? Think of it this way: High
estrogen is like pressing the “sensitivity” button on your brain's pain control panel,
turning the volume up to maximum.
It doesn't cause the attack yet, but it primes your system for pain. The sudden drop
in estrogen — the withdrawal — is the actual trigger; it's the moment someone yanks
the plug from the wall. That shock to the already hyper-sensitive system causes the
electrical chaos (cortical spreading depression) and the resulting migraine.
• Pregnancy and menopause each reshape migraine patterns in distinct ways —
During early pregnancy, when hormones shift rapidly to sustain fetal growth,
migraines often become more intense or unpredictable. However, as pregnancy
progresses and hormone levels stabilize, many women notice dramatic
improvement or even complete remission of attacks. After birth, the sudden
hormonal drop often reignites migraine episodes.
Perimenopause, the transitional period before menopause, brings another
unpredictable phase — random surges of estrogen from the ovaries often trigger
new or worsened attacks. Yet once menopause is reached and hormone levels
flatten, many women experience partial or total relief, illustrating how stability of
estrogen matters most.
• Mitochondrial inheritance explains why migraine tends to run in maternal family
lines — The Conversation also discussed how genetics — and specifically
mitochondrial DNA — help explain why migraines frequently appear in mothers,
daughters, and granddaughters. Mitochondria are the tiny energy generators inside
cells that produce adenosine triphosphate (ATP), your body’s main energy currency.
They’re inherited only from your mother.
People with migraines have fewer functional enzymes within their mitochondria,
meaning their brains operate in a constant state of energy deficit. When additional
stress — like lack of sleep, poor diet, or hormonal swings — further drains this
energy supply, a migraine is triggered. This insight links hormonal instability with
cellular energy dysfunction, showing why migraine management needs to address
both.
Brain Structure and Stress Patterns Explain Women’s Migraine
Burden
A narrative review published in Neurological Sciences explored how biological and
social differences between men and women influence migraine risk, symptoms, and
treatment outcomes.
5
The review found that global migraine prevalence is 20.7% in women and 9.7% in men,
with even larger gaps in countries like Italy, where 32.9% of women and only 13% of men
experience the condition. These numbers show why women often face greater daily
disruption, lost workdays, and emotional strain from chronic migraine than men.
• Women experience more intense, longer, and more disabling attacks than men —
According to the review, female migraine sufferers report longer episodes, higher
recurrence rates, and slower recovery compared with males. Women are also 1.34
times more likely to fall into the highest category of migraine-related disability.
The researchers attribute these differences to the combined effects of hormonal
fluctuations, stress response patterns, and brain structure — specifically, how
women’s nervous systems respond to sensory and emotional stimuli. Female brains
exhibit more pain-responsive regions, meaning stress, light, and noise produce a
stronger reaction.
• Workplace stress and sleep disruption compound migraine risk — The review also
highlighted night shifts, irregular sleep patterns, and emotionally demanding roles
influence migraine risk. Shift work disrupts your circadian rhythm — your body’s
natural sleep-wake cycle — which affects hormonal regulation and brain energy
metabolism. People working fixed evening shifts had up to 56% higher odds of
seeking migraine treatment compared to daytime workers.
6
• Environmental triggers at work create a hidden layer of risk — People exposed to
bright lights, chemical odors, or poor air quality in workplaces reported more
frequent headaches. The study linked these environmental stressors to “sick
building syndrome, ” a condition where prolonged exposure to indoor pollutants
worsens symptoms until leaving the environment brings relief.
• Hormones, genetics, and environment combine to shape women’s migraine risk —
The Global Burden of Disease study ranked migraine as the fourth leading cause of
years lived with disability for women, compared with eighth for men, according to a
report from the University of Colorado Anschutz Medical Campus.
7
Dr. Danielle Wilhour, assistant professor in the department of neurology, noted that
about 50% to 60% of women with migraine experience menstrual-related attacks.
Women with migraine also more often struggle with anxiety and depression, while
men tend to experience physical comorbidities such as obesity.
Wilhour added that women are more likely to adopt preventive approaches, while
men often treat migraines only after they begin. She also highlighted
neuromodulation devices that deliver mild electrical impulses to nerves in the head
or neck, interrupting pain transmission without drugs. These tools offer alternatives
for those who want to avoid migraine medications or reduce side effects.
Most Migraines Trace Back to Excess Linoleic Acid
While hormones and genetics play a role, most migraines stem from a deep-rooted
problem in your mitochondria — and one of the biggest saboteurs of mitochondrial
health is excess linoleic acid (LA). This polyunsaturated fat, abundant in seed oils and
other ultraprocessed foods, acts as a mitochondrial toxin that disrupts your cells’ ability
to produce energy efficiently.
• Excess LA damages your mitochondria, fueling inflammation and pain — When LA
oxidizes, it forms toxic byproducts. These compounds attack mitochondrial
membranes and proteins, blocking normal energy production. With less ATP , your
brain becomes far more vulnerable to migraine attacks.
• Damaged cardiolipin disrupts energy flow inside your cells — Cardiolipin, a
specialized fat in the inner membrane of your mitochondria, is essential for forming
“supercomplexes” that generate energy.
When too much LA replaces the healthier omega-3 fats that should be there,
cardiolipin loses its structure and no longer supports efficient ATP production. The
result: sluggish energy metabolism and increased oxidative stress, both of which
prime your brain for migraine pain.
• Impaired cell renewal lets damaged cells persist — Healthy cardiolipin also triggers
apoptosis — the process of clearing out malfunctioning cells. When oxidized LA
damages cardiolipin, this self-cleaning mechanism fails, allowing defective cells to
survive and perpetuate inflammation and dysfunction.
• Processed seed oils are the main culprits — The most common sources of LA are
vegetable, or seed, oils (soybean, corn, safflower, sunflower, canola), fried and
processed foods, restaurant meals, and grain-fed meats like conventional pork and
chicken.
Even many olive and avocado oils are adulterated with cheaper seed oils. Although
reducing your total LA burden takes time, early benefits appear within weeks as
healthier fats replace damaged ones in your mitochondria. Ideally, limit your LA
intake to below 3 grams per day. You can figure out how much you’re consuming
with my Mercola Health Coach app, which comes out later this year.
Practical Steps to Restore Mitochondrial Health and Prevent
Hormone-Driven Migraines
If you’re living with migraines, you already know how unpredictable and exhausting they
are. What’s less obvious is that the pain often starts deep inside your cells. When your
mitochondria struggle to make enough energy, your brain becomes more reactive to
stress, hormones, and environmental triggers. Restoring mitochondrial health, balancing
hormones, and protecting your nervous system are the keys to lasting relief.
1. Reduce LA to protect your mitochondria — Excess LA damages your mitochondria
and mimics estrogen, triggering migraines. To protect your brain’s energy system
and stabilize hormones, limit LA to under 3 grams per day by avoiding seed oils like
soybean, corn, safflower, sunflower, canola, and cottonseed, along with fried,
processed, and restaurant foods made with them. Choose stable fats such as grass
fed butter, ghee, or tallow instead.
To track your intake, I recommend you download my Mercola Health Coach app
when it’s available this year. It has a feature called the Seed Oil Sleuth, which
monitors your LA intake to a tenth of a gram. Lowering LA helps your mitochondria
recover, reduces inflammation, and helps lessen migraine frequency.
2. Support melatonin — your brain’s built-in antioxidant — Melatonin does much more
than regulate sleep. It shields your brain at the cellular level by neutralizing free
radicals and calming inflammation that drives migraine pain. To optimize it
naturally:
• Get bright morning sunlight to anchor your circadian rhythm — this raises
alertness during the day and boosts melatonin release at night.
• Limit blue light exposure after sunset by dimming lights, using incandescent or
salt lamps, and wearing blue-blocking glasses if you use screens.
• Sleep in total darkness to allow full melatonin release overnight. Studies show
melatonin can reduce headache frequency by 51%, intensity by 53%, and
duration by 46%, making it a strong natural alternative to pharmaceutical
drugs.
8
3. Rebuild your nutrient reserves to fortify brain energy — Migraines are often linked
to deficiencies in magnesium, B vitamins (especially B2, B6, folate, and B12),
vitamin D, and coenzyme Q10 (CoQ10). These nutrients are essential for healthy
mitochondrial energy production and nerve function. If you struggle with frequent
migraines, increase your intake of magnesium-rich foods — like leafy greens — and
consider magnesium threonate for better absorption into your brain.
For severe cases, intravenous (IV) magnesium often helps stop an attack
midstream. CoQ10 supports the same energy pathways and works best when
paired with magnesium over several months. Always aim to meet most of your
nutrient needs through whole foods first — the exception being magnesium,
because many are deficient and benefit from supplementation.
4. Care for your mouth to reduce inflammation throughout your body — Chronic oral
inflammation is a hidden migraine trigger. Studies show women with migraines are
far more likely to have gum disease or poor oral health. 9
Use a gentle, fluoride-free
toothpaste, skip alcohol-based mouth rinses, and brush your tongue daily or use a
tongue scraper.
Oil pulling with coconut oil daily helps draw out bacteria and support oral
detoxification. Visit a biological dentist twice yearly for deep cleanings and
comprehensive exams — small improvements in oral health make a big difference in
your overall inflammation load.
5. Find your personal triggers — and balance your hormones naturally — No two
migraines are exactly alike, but tracking your patterns gives you the power to
predict and prevent them. Keep a detailed migraine diary that records your sleep,
stress, meals, weather changes, and menstrual cycle.
Over time, you’ll start to see clear connections between hormonal shifts and
migraine attacks. Once you know when your triggers occur, you can act early —
hydrating more, stabilizing your meals, or using stress-reduction techniques before
symptoms begin.
For women whose migraines are clearly linked to hormonal fluctuations, supporting
natural progesterone balance can make a meaningful difference. Natural
progesterone helps calm brain excitability and offsets the pro-inflammatory effects
of excess estrogen that often trigger migraine pain.
In addition to lowering your estrogen burden and LA intake, aspirin is an
inexpensive and readily available option. As reported in a 2019 paper in The
American Journal of Medicine, properly dosed aspirin can safely and effectively
abort a migraine attack when taken early enough, and may also be used
preventatively in lower doses.
10
FAQs About Migraines in Women
Q: Why are migraines more common in women than in men?
A: Migraines affect women three to four times more often than men because of
hormonal differences, particularly fluctuations in estrogen and progesterone.
Estrogen increases brain sensitivity to pain, while drops in estrogen also trigger
migraine attacks. Women’s reproductive years — when hormone levels shift the most
— are also when migraines are most frequent and intense.
Q: How do hormones trigger migraine attacks?
A: High estrogen levels “prime” your brain for pain by increasing the sensitivity of
the trigeminal nerve, which regulates facial sensation and headache pain. The
sudden drop in estrogen that follows — such as before menstruation or after
childbirth — acts as the final trigger, setting off electrical instability and
inflammation that lead to migraine symptoms. Natural progesterone helps counter
these effects by calming nerve excitability and balancing estrogen activity.
Q: What role does mitochondrial health play in migraines?
A: Mitochondria are the energy producers in your cells, and when they’re
underperforming, your brain struggles to maintain stable energy. This energy deficit
makes you more prone to migraine attacks. Reducing LA from processed seed oils
and supporting mitochondrial nutrients like magnesium, CoQ10, and B vitamins help
stabilize cellular energy and reduce migraine frequency.
Q: Are there natural ways to prevent or lessen migraine attacks?
A: Yes. Focus on stabilizing hormones and supporting cellular health:
• Lower your intake of LA to under 3 grams per day.
• Get morning sunlight and avoid blue light at night to support melatonin
production.
• Eat nutrient-dense foods rich in magnesium and B vitamins, and consider
supplementation if necessary.
• Track your hormonal cycle and migraine triggers.
• Practice stress management, regular sleep, and relaxation therapies like
acupuncture or chiropractic care.
Q: What treatments or supplements are most effective for migraine relief?
A: Natural options that have shown measurable results include magnesium
threonate, CoQ10, vitamin D, melatonin, and natural progesterone support.
Melatonin alone has been shown to reduce headache frequency by more than 50%.
For acute relief, properly dosed aspirin — taken early in an attack — has been shown
to be both safe and effective, and it can also be used in lower doses for prevention.
Sources and References
1, 5
2, 4
3
6
Neurological Sciences June 8, 2022; 43(9):5729-5734
The Conversation October 19, 2025
Frontiers in Molecular Biosciences August 14, 2018
Ergonomics. 2017 Sep;60(9):1207-1217
7
8
9
10
University of Colorado Anschutz June 16, 2023
Medicine (Baltimore). 2019 Jan 18;98(3):e14099
Front. Pain Res. 2025;6
The American Journal of Medicine November 8, 2019; 133(4): 412-416
