Gender in business: the brains of men and women age differently
Women are more likely than men to suffer from depression and migraines, while epilepsy, on the contrary, is more common in men. These differences affect not only the picture of the diseases themselves, but also the rate of brain aging — mental health is closely related to the neurobiological mechanisms of aging. These conclusions were reached by Russian scientists as part of an international group of researchers. The data obtained will help select personalized therapy according to the patient's profile and develop new drugs, experts told Izvestia.
How Gender affects migraines and depression
Sechenov University has found out why men and women suffer depression, migraine and epilepsy differently. They outlined their findings in one of the chapters of the monograph "The role of gender and gender in aging and longevity," edited by Italian scientist Calogero Caruso from the University of Palermo. The work was presented at the conference of the International Association for Longevity Science in Abano-Terma in December 2025.
According to the data, gender influences how migraines occur, progress, and respond to treatment. On average, it occurs two to three times more often in women than in men. The seizures themselves also occur more frequently and are much more severe, even nausea. Moreover, the picture changes over the course of life: headaches usually begin during puberty, peak at fertile age and decrease after menopause. Women also have more triggers that can cause migraines. The three most common are menstruation (78%), stress (77%) and bright light (69%). In men, the three most common causes of migraines include stress (69%), bright lights (63%), and lack of sleep (60%).
Scientists attribute this to the role of hormonal fluctuations, especially estrogen, which "holds back" the pain systems of the brain. In men, testosterone can have a certain protective effect, which is probably why they experience migraines less often.
Stress is a non—specific but important trigger for migraines. At the same time, men and women have different stress tolerance and adaptability, which can affect the frequency and severity of seizures," said Professor Alexey Danilov, Head of the Department of Nervous Diseases at Sechenov University.
There is a similar pattern with depression, which women are twice as likely to experience as men. This gap begins at about age 12. The clinical picture is related to the reproductive cycle, fluctuations in the female hormones estrogen and progesterone — they affect emotions, metabolism and other biochemical processes that affect anxiety and depression, scientists say. One of the most dangerous periods is before menopause. At this time, the risk of depression recurrence increases four to six times, and the first episode increases two to three times. In addition, more than half of women with depression experience a premenstrual flare-up.
— More than half of women with depression experience premenstrual deterioration, and antidepressants may be less effective during this period. Therefore, it is important to pay special attention to your condition," said Anastasia Badayeva, a neurologist and an assistant at the Department of Pathological Physiology at Sechenov University.
The differences in the development of depression and migraines in men and women depend not only on hormones, the authors noted. Research shows that the genes of the sex chromosomes themselves actively influence the development of the brain as a whole and contribute to a person's addiction, risk, and pain perception. Functional MRI shows that women have a more pronounced development of the orbitofrontal cortex, which is associated with greater sensitivity to emotions. In men, the features of the gray matter structure and functional organization of the brain are associated with better adaptation to stress, doctors noted.
On the contrary, men suffer from another neurological disease, epilepsy, more often than women. Older men also have a higher risk of complications, including sudden death syndrome. This is due not only to changes in the hormonal background during life, but also to the basic functions of the brain, scientists believe.
— Neuroimaging has shown that structural abnormalities in epilepsy in women are more often localized in the temporal regions, and in men — in the frontal. We need to study these differences further in order to make the treatment of this disease more effective," Alexey Danilov is convinced.
Depression brings old age closer
The triggers that increase the risk of depression are also different for the sexes. For men, this is a feeling of unrealization, unfulfilled duty, loss of job or status, lack of support from friends. Women have little social activity, insufficient emotional support from their spouse, and family disharmony.
— An interesting phenomenon: these causes affect both the risk of depression and the acceleration of the aging process. In addition, late—onset depression and aging have a common mechanism — mitochondrial dysfunction, that is, a violation of the functions of organelles that are responsible for energy production for cells of different organs," explained the initiator of the work, Vittorio Calabrese, President of the European Society of Anti-Aging Medicine and professor of the Department of Nervous Diseases at Sechenov University.
If we compare the tolerance of severe depression between men and women, then suicide mortality is higher among the former. Women often have concomitant physical illnesses, including chronic pain, against the background of depression.
The novelty of the work lies in the discovery that differences in the course of migraine, epilepsy, and depression in men and women are due not only to hormonal background, but also to differences in neuroinflammation, energy metabolism, and neurovascular regulation, Anastasia Badaeva emphasized.
— It is incorrect to say that the brain of one of the sexes ages faster. Rather, we are talking about different aging trajectories: in men, the metabolic and vascular stability of the brain decreases earlier, in women, more pronounced age-related changes often occur after menopause, when hormonal and metabolic regulation changes," the researcher pointed out.
Treatment based on the portrait of a person
In general, understanding such processes is the key to truly personalized medicine, when treatment is selected not just by diagnosis, but based on a holistic portrait of a person — his gender, age, hormonal status and social situation, the authors of the monograph are convinced. Currently, scientists are considering the possibility of conducting their own research aimed at studying sex differences in pathogenesis, with the subsequent development of personalized therapeutic strategies.
Brain development in men and women occurs in a similar way, but there are differences. They depend on the hormonal background during the development, formation and aging of the nervous system, Mikhail Bolkov, a researcher at the Institute for the Study of Aging at the Russian National Research Medical Center of the Russian National Research Medical University, told Izvestia. The formation of neural connections in the brain lasts a lifetime, but the peak of work is reached around the age of 32. By this time, neural networks in the brain are being optimized and their mutual integration is increasing. This plateau of brain activity and its structure lasts on average up to 66 years, and after that some connections begin to break down, various parts of the neural network become more isolated.
— Around this age, neurodegeneration diseases such as Alzheimer's and Parkinson's begin to make their debut in some people. At the same time, special differences between the sexes have not yet been identified, but they have always been noted in detail, and, as the authors of the monographs correctly pointed out, including in neurology and the propensity of different sexes to various diseases," the scientist said.
As for depression, according to Vladimir Sokolov, a psychiatrist and an assistant at the Department of Psychiatry and Medical Psychology at the RUDN University, there is a greater prevalence of this disease in women than in men (ratio 1:2).
— In general, depression reduces life expectancy, we can say that the patient suffering from it ages faster. Depression reduces the production of neurotrophic factor in the brain, which stimulates the growth and development of neurons. Thus, untreated depression increases the risk of developing dementia, acquired dementia, in the long term," the specialist noted.
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