Migraine Myth of the Month Revisited: Female migraineurs are hyposexual
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In the Summer 2023 issue we presented data from research recently conducted by this editor and his colleagues that appeared to contradict the proposition that females with migraine are deficient in libido. In that article I also described my experience of having presented these data in precisely the same manner to two different audiences – one predominantly American at a national headache meeting in Austin, Texas, and the other predominantly European at an international neurology meeting in Budapest two weeks later. The same presentation was received very differently: with a palpable lack of enthusiasm - and even some hostility - by the predominantly American audience and quite positively by the predominantly European audience.
I found that contrast a bit difficult to fathom but definitely interesting, and this revisiting of the last issue’s “Myth” is intended to address the American response in particular. More important is the opportunity to explain how the results from research can give rise to new hypotheses that may involve issues of far greater significance than that which generated the original hypothesis.
As I indicated, even mid-presentation in Austin I could sense that all was not going well. This was far from my first rodeo; after a few decades of presenting to audiences of your peers in groups ranging from a handful to a few thousand, you get to know when you’re in the groove. Or not. The question and answer session that immediately followed my presentation was brief and uncomfortably strained. A few old friends in the audience tossed me a couple of slow pitch/easy hit questions, the moderator asked if there was anything else, and there was only silence. That was it.
I shrugged it off, returned to my room, changed from coat and tie to T-shirt and shorts and went kayaking with my wife.
A few days after I’d returned home I received a call from one of the chairs who had organized the scientific meeting in Austin. Seemed like a nice young guy. Perhaps a bit embarrassed. He advised me that a number of those attending my presentation had found my remarks offensive and asked how I would feel about having my more offending slides and remarks edited from the recorded archives of the meeting. I told him I would feel just fine.
So what specifically might the offended have found offending? Let’s see…
Before launching into a description of our research, I introduced the topic by remarking that it had been a somewhat daunting prospect to undertake an exploration of female sexuality during a time when there exists so much controversy and sensitivity regarding the topics of gender, sex, sexual orientation, and sexuality. As an example, I noted the response made by a now-sitting Supreme Court justice to a question posed to her during her confirmation hearing (Q: can you provide a definition for the word “woman”? A: “I’m not a biologist.”).
As to that question (what is a woman?), I noted that a computer-assisted analysis of 3.5 million books published between 1900–2008 found the adjectives most commonly used to describe women were “beautiful’ and “sexy“, while men were most commonly described as “righteous“, “rational” or “brave“.
I noted that as of February 2014 Facebook offered 58 gender options for user purposes, (including “two-spirit”).
Finally, I mentioned that in my Other Life I’m a writer, and when engaged in creative writing and stuck for a well-turned phrase or pithy epigram, I often have looked to Oscar Wilde. Of women, Wilde wrote: “Men can be analyzed, but women…merely adored.” Maybe it was this Oscar Wilde quote, but c’mon. Is it really offending to be adored? Is one less of a person, less of a female, less, say, of a female physician scientist if the individual is adored? For myself, I sincerely hope that all those whom I love hold in their hearts some adoration for me. I certainly adore them.
And…give me a break: if I didn’t think females and their sexuality were susceptible to analysis, would I have bothered to undertake this particular research?
Or maybe it was the nature of the research itself. Or the researcher. Perhaps this audience found it offensive that a (gracefully) aging white male should be so … (so what? intrusive? misogynistic? just generally inappropriate?) as to presume to investigate such complex and highly subjective issues as female sexual desire, performance, and satisfaction.
Enough. That I offended is clear. That I consciously sought to be offensive is…a myth. What I sought was clarity regarding an unsettled issue. Thanks largely to cultural inertia it has become widely accepted as a given that female migraineurs are hyposexual. Our research clearly suggests that this may be quite off the mark. At least in our study population and in what is to my knowledge the largest study of its kind to date, it is the converse that is true: heterosexually, self-identifying and sexually active females with migraine have a higher level of self-perceived sexuality, more positive sexual function, more intercourse and more sexual satisfaction than matched controls free of migraine.
Could this possibly explain why migraine - known to be present in human society for thousands of years - has escaped the merciless scythe of evolution? avoided natural selection pruning it from the shrub of the human genome? The primary purpose of natural selection is propagation of the species. If migraine does convey an increase in female libido and, with this, increased heterosexual activity favoring an increase in progeny, migraine conceivably may be advantageous to the human species. If true, is it possible that over the centuries to come we will witness a progressive increase in the proportion of migraineurs within the general population? In other words, natural selection favoring migraine?
And… presto! Thus one hypothesis (female migraineurs are no less “sexual” than female non-migraineurs) gives rise to a much more far-reaching hypothesis. Albeit an hypothesis that likely will require a multi-generational prospective study to prove.
