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why is it so hard for women with cluster headaches to get a diagnosis?

researchers say that doctors "should 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 headaches are considered a male dominated condition
women were more likely than men (18 per cent vs. nine per cent) to be diagnosed with chronic cluster headache. getty
cluster headaches have long been considered a male-dominant disorder, a misconception that means longer time to diagnosis for women, according to a new study.

the research, published in the journal neurology , defined cluster headaches as relatively brief, but extremely painful, episodes that can persist for days or weeks on end. the headaches themselves, which typically last between 15 minutes and three hours, are rare and not life-threatening.

cluster headaches typically produce intense pain around the eye and temple of one side of the face, according to migraine canada . the attacks, which have been likened to pushing a hot poker into one’s face, are experienced by thousands of canadians every year, with a proper diagnosis often taking years to complete. fortunately, treatments are available to shorten the length of attacks and medication can help reduce the frequency with which they occur.

“cluster headache is still often misdiagnosed in women, perhaps because some aspects can be similar to migraine,” said andrea c. belin , author of the study from 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.”

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to arrive at their results, researchers recruited 874 people (66 per cent male, 34 per cent female) who had been diagnosed with the disorder and asked them to complete a detailed questionnaire about their experiences with cluster headaches, including any relevant symptoms, triggers, medications and lifestyle habits.

women experience longer attacks than men

they found that women were more likely than men (18 per cent vs. nine per cent) to be diagnosed with chronic cluster headache, a condition in which cluster headaches endure for one year or more without interruption, or with an interruption that lasts less than three months.
women also experienced longer lasting attacks, with eight per cent of women (compared to five per cent of men) reporting their bouts lasted four to seven months, on average. they were also more likely than men to experience bouts lasting less than a month (26 per cent vs 30 per cent).
according to researchers, the symptoms experienced by women tended to occur more often at different times throughout the day than those of men (74 per cent vs. 63 per cent) and women were more than twice as likely as men to have a family member with a history of the condition.
“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,” belin said. “it’s possible this could contribute to the higher rate of chronic cluster headache in women.”

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because the study, which was supported by the swedish brain foundation among others, relied on self-reporting, the results may be limited by the ability of participants to correctly recall their symptoms and experiences over time.

dave yasvinski is a writer with  healthing.ca

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