Differentialities in gender when it comes to headache treatment are prevalent among veterans of the United States with women more likely to be diagnosed of tension or migraine headaches however, men were more likely to be diagnosed with headaches caused by the trauma of their lives or to cluster headaches as per research published in Neurology..

Researchers conducted an analysis of a retrospective cohort to determine the gender-based differences that exist in migraine diagnosis between American veterans who received treatment to treat headaches from 2008 to 2019. The study was conducted by the Veterans Health Administration (VHA). They found 1,562,036 veterans who had at least one outpatient or inpatient appointment in connection with the diagnosis of headache during the study.

Utilizing EHR (EHR) information provided by the VHA The researchers accessed the ICD-9 as well as ICD-10 codes to identify and categorize headache diagnoses into eight categories. These include:

  • headaches of the tension type
  • trigeminal autonomic cephalalgias
  • migraine
  • headache, not-otherwise-specified (NOS)
  • posttraumatic headache
  • Post-whiplash headache
  • Other primary headache disorders as well as
  • Other secondary headache disorders.

The study found that, in comparison to women, men were typically White (70.4 percent in comparison to 56.7 percent) older (52.0+-16.8 vs. 41.9+-13.0 years) and also were more likely to suffer from trauma brain injury (TBI; 2.9% vs 1.1 percentage) as well as posttraumatic stress disorder (PTSD; 23.7% vs 21.7 percent). Men, however, were less likely to suffer from sexual assaults in the military (3.2 percent as compared to 33.7 percent; P <.001 For all)

The researchers also found that men more often than women received diagnosis for post-traumatic headaches (3.4 percent against. 1.9 percent; P <.001) Post-whiplash headache (5.5 percent as compared to. 5.1 percent; P <.001) as well as cluster headache (1.7 percent vs. 0.9 percent) and headache NOS (77.4 percentage (vs. 67.7 percent; P <.001).

There are significant gender differences between female and male Veterans who receive headache care from VHA with respect to sociodemographic traits as well as headache diagnosis as well as exposure to military activities and the use of headache healthcare.

Men had fewer types of headaches identified (mean, 1.3 vs. 1.5; P <.001) typically experiencing one type of headache identified compared with women (75.0 percent and. 61.6 percent and 61.6%, respectively). As compared to women, males had fewer visits to specialists with headaches each year (0.8 per year vs. 1.2; P <.001) and a lesser amount of visits to doctors for headaches (20.8 percentage as compared to. 27.4 percent; P <.001) as compared to women.

Contrary to this the females were significantly more likely seek treatment at an emergency room for headaches as compared to men (22.9 percent and. 20.3 percent; P <.001). Women were more often diagnosed with diagnoses of migraine (60.1 percent against. 32.4 percent) migraine, tension-type headache (8.2 percentage in comparison to. 7.0 percent) and other primary headaches (3.2 percentage in comparison to. 2.9 percent) as well as other secondary headaches (1.3 percentage (vs. 1.0 1.3% vs. 1.0).

“Important gender differences exist between both women and men Veterans receiving treatment for headaches within VHA in terms of sociodemographic characteristics as well as headache diagnosis as well as exposure to military and the use of headache healthcare,” the researchers stated. “The findings could have implications for healthcare providers as well as the health system that cares for Veterans who suffer from headaches.”

The study’s limitations were mainly generalizability beyond the predominantly male veterans population, distinction of headaches including gender-specific genders, including transgender and non-binary and examination of the types of headache depending on the branch of military in which the veteran served as well as possible misdiagnosis of headaches and the under-coding of specific headache diagnosis. In addition, the researchers did not examine the effects on headache treatment as well as mental and physical health conditions on the diagnosis of headaches or the frequency of utilization of health services.

Disclosures: Certain study authors have disclosed affiliations with pharmaceutical, biotech and/or device manufacturers. Refer to the original source for a full listing of disclosures made by authors.


Sico JJ, Seng E, Wang K, et al. The characteristics and gender-specific differences of headaches among the Veterans Health Administration: a nationwide cohort study from 2008 to 2019 fiscal year. Neurology. Published online September 13, 2022. doi:10.1212/WNL.0000000000200905