Sex differences in patients' referral to a headache unit

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Migraine affects women 2-3 times more than men.
• Sex differences in migraine referral and treatment pathways are understudied.
• Understanding these differences is crucial for equitable care.

Purpose of the Study:

• To analyze sex distribution in patients referred to a Headache Unit.
• To evaluate age differences, consultation time, and treatment management based on sex.
• To identify sex-based disparities in migraine care pathways.

Main Methods:

• Retrospective observational study of a prospectively collected migraine patient registry (2008-2025).
• Analysis of demographic data (sex, age), headache history (disease duration), and prior treatment use.
• Inclusion of patients diagnosed with migraine at a tertiary hospital Headache Unit.

Main Results:

• Females constituted 79.7% of 6,220 migraine patients.
• Females were referred at an older age (39.9 vs. 37.1 years) with longer disease duration (18.1 vs. 14.9 years).
• Females were more likely to have received triptans (28.6% vs. 21.5%) and preventive treatment (39.5% vs. 31.8%) prior to referral.

Conclusions:

• Female migraine patients experience delayed referral and longer disease duration.
• Men with migraine showed lower utilization of specific treatments like triptans and preventives.
• Significant sex-based differences exist in migraine referral and treatment exposure.