AAN 2025 | Treating migraine in women with a multidisciplinary approach
Piero Barbanti, MD, PhD, IRCCS San Raffaele Pisana, Rome, Italy, highlights the complexities of treating migraine in women, emphasizing the unique hormonal and physiological factors that make female patients more susceptible to severe and treatment-resistant migraine episodes. He emphasizes the need for collaboration with gynecologists, endocrinologists, and other specialists to support women through different life stages. Prof. Barbanti states that personalized care and communication across specialties are often essential to ensure safe, effective, and well-tolerated migraine therapies for women. This interview took place at the 77th American Academy of Neurology (AAN) Annual Meeting in San Diego, CA.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
Migraine is much more prevalent in females than in males. This can be due to the intrinsic nature of migraine. Migraine is a useless hyperfunction of the brain. The brain defense and female brain is hyperactive and has a higher connection speed compared to the male one. We know that females have more frequent migraines compared to males, but their migraines are also usually more severe...
Migraine is much more prevalent in females than in males. This can be due to the intrinsic nature of migraine. Migraine is a useless hyperfunction of the brain. The brain defense and female brain is hyperactive and has a higher connection speed compared to the male one. We know that females have more frequent migraines compared to males, but their migraines are also usually more severe. Furthermore, females have migraines that are harder to treat during their menstrual cycles because those who are in their reproductive life easily recognize that menstrual-related migraines, menstrual migraines, are much harder to treat, are more disabling, and respond less to acute treatment. And also, they have a trend to remain even when the patient follows a proper preventive treatment. We should approach female migraine in a multidisciplinary manner. Why? Because we know that, for example, females may need hormones, may use oral contraception or other kinds of non-oral contraception. Then they may deserve hormonal supplementation following menopause, again, because they may have residual migraines at the beginning of their pregnancy or during breastfeeding. So we should work in contact with gynecologists, for example, but also with pharmacologists, sometimes with endocrinologists and sometimes also with oncologists, because we know that, for example, when a female patient has breast cancer and receives hormonal treatment which is aimed at blocking ovarian function, the headache and migraine may worsen. So, there are several women inside the single woman across her lifespan. And so, the neurologist, the headache specialist should be aware that the cooperation with other colleagues is needed, sometimes mandatory to provide to the female patient the best treatment, the safest treatment, the most tolerated treatment during her life. For example, we should inform gynecologists if the patient is affected by migraine so that estrogen should be avoided. This is just one single example of cooperation.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
Read more...
Disclosures
Personal fees: Over the last five years has served as consultant, advisory board member, or has received honoraria from Abbvie, Angelini, Assosalute, Bayer, DOC Pharma, Eli-Lilly, Fondazione Ricerca e Salute, Lundbeck, New Penta, Novartis, Organon, Orionpharma, Pfizer, Teva, Viatris, Visufarma, Zambon, and has been the PI in trials sponsored by Abbvie, Alder, , Amgen, Astra-Zeneca; Bioheaven, Chordate, , ElectroCore, Eli-Lilly, GSK, Lundbeck, New Penta, Noema Pharma, Novartis, Pfizer, Teva.
