Cluster headaches may be more common in men but they are more severe in women, new research suggests.
The short but extremely painful headaches can occur many days, or even weeks, in a row, and last anywhere from 15 minutes to three hours.
Study author Andrea Belin, of the Karolinska Institutet in Stockholm, Sweden, said: “Cluster headache is still often misdiagnosed in women, perhaps because some aspects can be similar to migraine.
“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.”
The study involved 874 people diagnosed with cluster headache, with 66% male and 34% female.
People answered a questionnaire about their symptoms, medications, headache triggers and lifestyle habits.
According to the study, women were more likely to be diagnosed with chronic cluster headache than men.
This is defined as recurring cluster headache attacks for one year or more without interruption, or with short intermissions with no symptoms that last less than three months.
The study found that 18% of women were diagnosed with chronic cluster headache, compared to 9% of men.
Attacks also lasted longer for women than for men.
In the study 8% of women reported that headache bouts lasted an average of four to seven months, compared to 5% of men, while 26% of women said bouts on average lasted less than one month, compared to 30% of men.
Women were also more likely to report that their attacks occurred at various times throughout the day than men, 74% to 63%.
And women were also more likely than men to report a family history of cluster headaches – 15% to 7%.
Dr Belin said: “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.
“It’s possible this could contribute to the higher rate of chronic cluster headache in women.”
The researchers highlight that because the information was reported by the participants, they may not have remembered everything correctly.
The findings are published in the Neurology journal.