Menstrual Migraine Prevalence High Among US Premenopausal Women

More than half of women with menstrual migraine experience moderate-to-severe disability with this condition, according to study results presented at the 2024 American Academy of Neurology (AAN) annual meeting, held from April 13 to 18, 2024, in Denver, Colorado.

Existing literature regarding the prevalence of menstrual migraine varies greatly, and there is a lack of research regarding potential treatments for this condition. Researchers conducted a retrospective, cross-sectional study to describe the characteristics and understand the prevalence of menstrual migraine in the US.

The researchers collected data from the 2021 US National Health and Wellness Survey (NHWS) and recruited women participants diagnosed with migraine who reported their migraine was associated with their menses. Separate analyses were conducted for all women and for premenopausal women. The analysis of premenopausal women divided women with regular or irregular menstruation into age groups of 18 to 39 and 40 to 55. The Migraine Disability Assessment Test (MIDAS) was used to collect information regarding migraine treatment, frequency, and disability. 

A total of 19.8 million women diagnosed with migraine were identified in the database, 11.8 million of which were considered premenopausal. Of these participants, 6.2 million reported menstrual migraine, leading to a 31.0% menstrual migraine prevalence among all women and 52.5% in premenopausal women.

Among women reporting menstrual migraine, the average age was 33.2, 52.6% reported a partner or were married, 66.6% were employed, and 38.2% were considered obese. 

The average frequency of monthly migraine headache days was 8.4 days and an average monthly migraine attack of 4.5. Over half (56.2%) of women had moderate-to-severe migraine-related disability. The average MIDAS score was 24.8, with higher scores indicating worse disability. 

A total of 42.4% of women with menstrual migraine reported the use of only over-the-counter medications, while 48.6% indicated the use of prescription medications. Of the women with menstrual migraine using medications, 63.9% used treatments for acute migraine and 21.1% for prevention of migraines.

Patients most common medication used were triptans (36.7%) with an average of 3.9 days of use, nonsteroidal anti-inflammatory drugs (31.1%) with an average of 8.1 days (SD, 8.2 days) of use, and opioids (22.2%) with an average of 7.9 days of use.

“The prevalence of MM [menstrual migraine] was 31-52% among women and more than half of women with MM reported moderate-to-severe disability associated with their migraines. Acute medication use was common, including 42.4% who reported managing with non-prescription acute treatments and low overall use of preventative therapies (21.1%),” the researchers concluded.