{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:06:34Z","timestamp":1775145994789,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine is two to three times more prevalent in women than in men, yet sex-related differences in referral patterns and treatment pathways remain insufficiently studied. The objective of the study was to analyze sex distribution upon arrival at a Headache Unit. Secondary objectives included evaluation of age differences, time to first consultation and treatment management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study based on a prospectively collected registry of patients diagnosed with migraine at the Headache Unit of a tertiary hospital, between January 2008 and January 2025. Variables included demographic data such as sex or age at referral, headache variables including years since migraine onset and previous use of symptomatic or preventive treatment as well as primary care or secondary care referral.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 6,220 patients with migraine 4,956 (79.7%) were female. Female patients were referred at an older age (39.9 vs. 37.1\u202fyears;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004) with longer disease duration (18.1 vs. 14.9\u202fyears;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001). They were more likely to have received triptans (28.6% vs. 21.5%) and preventive treatment (39.5% vs. 31.8%) prior to referral (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001 for all). These trends persisted among patients referred from primary care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Female patients were referred to a Headache Unit at an older age and after a longer disease duration, while men were less likely to have received specific migraine treatments such as triptans or preventives. These findings highlight relevant sex-based differences in referral patterns and treatment exposure among patients with migraine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1755865","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:43:17Z","timestamp":1768398197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex differences in patients\u2019 referral to a headache unit"],"prefix":"10.3389","volume":"16","author":[{"given":"Elena","family":"Varas-Mart\u00edn","sequence":"first","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Ros-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lvaro","family":"Sierra-Menc\u00eda","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Recio-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Caballero-Lillo","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y\u00e9sica","family":"Gonz\u00e1lez-Osorio","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo","family":"Areses-Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"S\u00e1nchez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Luz.","family":"Pe\u00f1as-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Gonzalez-Martinez","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]},{"name":"Hospital Universitario de la Princesa","place":["Madrid, Spain"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa)","place":["Madrid, Spain"]},{"name":"Universidad Aut\u00f3noma de Madrid (UAM)","place":["Madrid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel L.","family":"Guerrero-Peral","sequence":"additional","affiliation":[{"name":"Headache Unit, Neurology Department, Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]},{"name":"Department of Medicine, Universidad de Valladolid","place":["Valladolid, Spain"]},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Valladolid (IBioVALL)","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/S0140-6736(20)31561-0","article-title":"Sex and gender: modifiers of health, disease, and medicine","volume":"396","author":"Mauvais-Jarvis","year":"2020","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2841","DOI":"10.1016\/S0140-6736(16)32392-3","article-title":"Editorial policies for sex and gender analysis","volume":"388","author":"Schiebinger","year":"2016","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1111\/j.1526-4610.2011.01900.x","article-title":"Sex matters: evaluating sex and 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