Many men don't realize they have migraine pain

- Headache pain is one of the top 5 reasons people end up in the ER.  But only about half of the 37 million migraine sufferers in the US have ever been formally diagnosed with the neurological disorder, according to the National Headache Foundation. About 3 times as many women as men experience migraine attacks.

A recent Dutch study shows one of the main triggers of a migraine in women, fluctuating estrogen levels, may also trigger the episodes in men.Dr. Gregory Esper, an Associate Professor of Neurology and Vice President of Clinical Affairs at the Emory School of Medicine, says many men don't know much about migraine headaches. So, they may not even realize they're experiencing them.

"Migraine is under-diagnosed in men," Dr. Esper says. "A lot of men don't know they have migraine, they just think they have a sinus headache or a regular headache."

It's not clear what causes a migraine, which affects nerve pathways and chemicals in the brain, but 70 to 80 percent of sufferers have a family history of the disorder. And small things, like sleep disruptions, eating the wrong foods, or missing meals can trigger an attack. Dr. Esper says a migraine comes with certain features.

"It has to be at least moderate to severe in pain, typically of a throbbing or pulsating quality, and it has to last for a period of time, between 4 and 72 hours," he says.

A headache that worsens with exertion, is one-sided, or causes sensitivity to light and sound, or is accompanied by nausea and vomiting may also be signs of a migraine. Some sufferers experience visual disturbances. Dr. Esper says a migraine can be treated with medication to stop the attacks once they begin or drugs to reduce the frequency and severity of the episodes. If headache pain is disrupting your day to day life, Esper says, talk to your doctor.

"Even if they have headaches that are more frequent than they think should be happening, they should be asking their primary care doctor," he says.

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