Why women get more migraines, and what to do about it

By

Norah O'Donnell

Co-host, "CBS Mornings" & Correspondent, "60 Minutes"

Norah O'Donnell is a multiple Emmy-Award winning "60 Minutes" correspondent and co-host of "CBS Mornings." Previously, O'Donnell served as the managing editor and anchor of the "CBS Evening News" for more than five years, in addition to anchoring CBS News election specials. O'Donnell is also the host of "Healthful with Norah O'Donnell," a CBS News podcast focused on women's health.

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November 11, 2026 / 7:00 AM EST / CBS News

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Thirty-seven million Americans suffer from migraines, and women are three times more likely to get them than men.

Not only are migraines physically debilitating, they are very costly in terms of medical expenses and lost productivity. The World Health Organization even states that migraines are one of the top 10 most debilitating illnesses globally.

Despite being such a common illness, doctors and researchers don't know exactly what causes migraine.

Dr. Jessica Ailani is a board-certified neurologist with a specialty in headache disorders. As the director of MedStar Georgetown Headache Center in Washington, D.C., she studies migraines and treatment. 

What are migraines?

Ailani wants to make abundantly clear that a "migraine is more than a headache." The condition can last from hours to days and have several phases.

The "prodrome" phase can start up to a day before the migraine, with over 36 potential symptoms like irritability, sensitivity to light and sound, nausea, neck pain, and even food cravings. Some individuals experience an "aura" — vision changes like flashing lights — during migraine attacks. 

During a migraine, patients experience debilitating head pain, sensitivity to light and sound, nausea and insomnia, among other symptoms, sometimes for upwards of 72 hours.

The final phase is called "postdrome" and includes an inability to concentrate, fatigue and low mood. The symptoms can last up to two days.

All three phases make up the migraine and often lead to people missing school, work and events to cope with the pain. 

What causes migraines?

While there is still some mystery around what causes migraines, Ailani believes they are "primarily a genetic disorder." However, there are several different genes related to migraines "in one way or another," and scientists have found it challenging to pinpoint which specifically cause them. 

"Somewhere in the early '90s, there were a couple of big discoveries … where they started to realize that migraine is not an abnormality of blood vessels, but actually an abnormality of proteins that are released that can increase inflammation and cause this network error to occur," she explained.

People with a family history of migraines have genes that make "the brain more sensitive to having these cycles where there's more abnormal electric activity," Ailani said. "A release of proteins at the wrong time that are causing inflammation and network problems" is experienced as these intense headaches called migraines.

How hormones influence migraine attacks

Ailani said little was taught about hormones when she was in medical school. But she has come to realize "hormones are so incredibly important in everything." 

This interaction between hormones and migraines may provide an explanation as to why women are three times more likely to suffer from migraines than men.

Before puberty, boys are actually more susceptible to migraines than girls. But, once the first menstrual cycle occurs, a female's "chance of developing migraines starts to increase tremendously."

A second peak of migraine attacks in a woman's life occurs in their 40s, when there seems to be "a lot of shifting hormones" and estrogen levels become unstable. This instability is also an indication of why when a woman is pregnant there "is almost a complete resolution of [migraine] attacks," according to Ailani, because estrogen levels tend to be steady and strong.

On the other end of the hormone spectrum, there are theories that testosterone might be a protective hormone against migraines.

Interestingly, at menopause, when women often experience other symptoms because of imbalanced hormones, "for many women migraine improves," Ailani said. If a woman starts getting migraines at menopause, she recommends consulting a doctor about the possibility of using menopausal hormone therapy.

Botox for migraines

There has been a lot of progress in finding better treatment for migraines and offering symptom relief to patients. Botox is a common and effective treatment that can help manage chronic migraines.

The injection is not the same as ones used for aesthetic procedures. The needle needs to go deeper and can be temporarily painful. Ailani says the treatment is so "effective that people keep coming back."

Ailani notes that Botox — a form of botulinum toxin — is the only FDA-approved toxin for treatment of chronic migraines, but there are others being studied that show promise as possible treatments for chronic and episodic migraines.

Innovations in migraine treatment

"One treatment doesn't work for every patient," Ailani said. Her team at MedStar has been on the forefront of developing new technologies and treatments to manage and even prevent migraine occurrence.

The goal, as Ailani puts it, is to "get a person to zero, to migraine freedom, to living their fullest life." 

One of the biggest developments in the field is a CGRP inhibitor. This type of prescription medication blocks calcitonin gene-related peptide, a small protein in the nerves in your head and neck that scientists believe plays a role in migraine pain.

What's particularly "unique," according to Ailani, is that taking CGRP inhibitors will also help prevent future migraines, becoming more effective over time.

There are also non-pharmaceutical options that Ailani recommends to patients, like Remote Electrical Neuromodulation, or RENs. These devices are applied to a patient's upper arm and send electrical charges into the muscle to stimulate nerves that "turn off the brain's pain button."

Advances in the field give Ailani hope that someone with migraines "can definitely live a much better life under the right treatment."

"Put yourself first"

Ailani had a message specifically for women living with migraines: "We're very good at … not taking care of ourselves and taking care of everyone else and saying that whatever's wrong with us is just nothing." 

Women sometimes remain silent about their health issues, thinking their pain is normal or part of being a woman. 

"Put yourself first," Ailani said, calling it one of the "most important things to remember."

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