Trigeminal neuralgia in women: why the evidence can no longer be ignored
By Aneeta Prem MBE
International Women’s Day 2026
International Women’s Day often focuses on opportunity, leadership and visibility. It should also prompt a more uncomfortable question: which women carry the heaviest burden of disease, and why does that burden remain poorly recognised?
Trigeminal neuralgia is one such condition.
It is routinely described as rare, yet evidence indicates that women are affected more often than men. The consequences are clinical, psychological and structural. They extend far beyond neurology clinics.
Women are disproportionately affected
A 2026 systematic review and meta-regression covering studies from 1945 to 2024 reported higher pooled incidence and prevalence estimates for trigeminal neuralgia in women than in men. The authors were appropriately cautious about subgroup certainty, but the overall direction was consistent.
The TNA UK Patient Experience Survey 2025 also had a strong female majority: 70% of respondents were women and 30% were men. That survey reflects people who chose to respond, so it should not be treated as a population prevalence study. It nevertheless provides important evidence about the experience of people seeking support in the UK.
A long-term condition
In the TNA UK survey, 41% of respondents reported living with trigeminal neuralgia for more than ten years. Long duration increases cumulative psychological strain, exposure to medication and the gradual narrowing of daily life.
One respondent wrote: “My world shrank to my bedroom.”
Mental health must be part of care
Eighty per cent of respondents reported a negative effect on mental wellbeing. Thirty-one per cent reported suicidal thoughts, and 64% of those said they had not disclosed this to a healthcare professional.
These findings apply to the survey sample as a whole. They should not be presented as female-only results because the individual responses were not analysed by sex for each outcome.
The figures still show a serious need for routine, sensitive mental-health support alongside neurological care.
Misdiagnosis causes further harm
Forty-two per cent of survey respondents reported being misdiagnosed with a dental problem before trigeminal neuralgia was identified. Some described repeated dental referrals or unnecessary procedures.
Diagnostic delay prolongs pain, erodes trust and can leave people doubting their own experience. Better pathways between dentistry, primary care, neurology and specialist facial-pain services are needed.
Medication burden
Eighty-eight per cent of respondents had tried anticonvulsant medication. Many find these medicines helpful, but respondents also described sedation, cognitive fog, balance problems and emotional flattening.
When women form a large majority of the patient population, treatment tolerability has consequences for employment, caring responsibilities, relationships and independence.
What the evidence shows
- Global epidemiological research reports that trigeminal neuralgia affects women more often than men.
- The TNA UK survey sample had a strong female majority and showed long disease duration, substantial mental-health impact and frequent dental misdiagnosis.
- Suicidal thoughts were reported by nearly one third of respondents and were often undisclosed.
What remains uncertain
- The evidence does not yet explain fully why women are affected more often.
- It does not establish a hormonal or menopausal mechanism.
- Sex-stratified treatment evidence remains limited.
- The TNA UK outcome data should not be interpreted as female-only unless analysed that way.
Why this belongs in women’s health policy
Women’s health strategies often focus on reproductive life stages. Trigeminal neuralgia also deserves attention because it sits at the intersection of chronic neuropathic pain, mental-health risk, ageing, disability and social isolation.
Care must reflect chronicity. A condition lasting ten years or more cannot be managed adequately through fragmented referrals and short appointments alone.
Support
Anyone experiencing suicidal thoughts or feeling at immediate risk should seek urgent help through emergency services or a healthcare professional. TNA UK provides information and peer support for people affected by trigeminal neuralgia and facial pain.
TNA UK, The Facial Pain Charity
Sources
- Jeong YD et al. Global incidence and prevalence of trigeminal neuralgia, 1945–2024: a systematic review and meta-regression analysis. Journal of Clinical Neurology, 2026.
- Trigeminal Neuralgia Association UK. Patient Experience Survey, 2025.
About Aneeta Prem
Aneeta Prem MBE is Chief Executive of TNA UK and lives with bilateral trigeminal neuralgia. She writes about patient experience, diagnosis, neurological pain and access to care.
