Burden of migraine related to menses: results from the AMPP study

Abstract

BackgroundStudies of the difference between menstrually associated and non-menstrually associated migraine are somewhat controversial. The majority of studies have focused on comparing menstrual to non-menstrual attacks rather than comparing study groups with different migraine diagnoses with respect to menstruation. As there is limited knowledge available on the overall impact and burden of migraine among groups of women with and without menstrually associated migraine our goal was to examine differences between these groups. We hypothesized that there would be greater burden of migraine related to menstruation and headache frequency in a population study across groups of women.MethodsWe analyzed data from the American Migraine Prevalence and Prevention (AMPP) Study, a longitudinal, US, population-based study. We included female respondents to the 2009 survey, aged 18 to 60, who met modified ICHD-2 criteria for migraine, were actively menstruating and fit one of three definitions based on the self-reported association of menses and migraine attacks: self-reported predominantly menstrual migraine (MM, attacks that only or predominantly occur at the time of menses), self-reported menstrually-associated migraine (MAM, attacks commonly associated with menses, but that also occur at other times of the month), and self-reported menstrually-unrelated migraine (MUM). These three groups were compared on characteristics and measures of headache impact and burden (Headache Impact Test– 6 item (HIT-6) and Migraine Disability Assessment Scale (MIDAS).ResultsThere were 1,697 eligible subjects for this study in the following categories: MM (5.5%), MAM (53.8%), or MUM (40.7%). Women with MM had an older age of migraine onset. Those with predominantly menstrually-related attacks (MM) had fewer headache-days but appeared to be more impaired by attacks. HIT-6 and MIDAS scores were significantly higher for both the MM and MAM groups compared with the MUM groups; however, effects were more robust for MM than MAM.ConclusionsNearly 60% of women with migraine reported an association between migraine and menses. These women reported greater headache impact and migraine-related burden on functioning than those in whom migraines were not related to menstruation. Women with MM were more impaired by attacks while women with MAM had overall highest burden, likely due to experiencing migraines on additional days.

<p>Menstrual-Related Headaches Among a Cohort of African Adolescent Girls</p>

“…Just like we have established, the American Migraine Prevalence and Prevention (AMPP) study found that women with MM were more impaired by attacks while women with MAM had overall highest burden, likely due to experiencing migraines on additional days. 24…”

Sex‐related influences in migraine

“…Approximately 18% of women and 6% of men in the United States are affected by migraine, a neurovascular disorder characterized by recurrent headache attacks involving nausea, photophobia, phonophobia, and exacerbation by physical activity (Stewart et al, ; Bigal et al, ). Migraine is the fourth leading cause of disability in women worldwide, with women migraineurs experiencing significant burden of disease (Hu et al, ; Lipton et al, ; Pavlovic et al, ) compared with men (Buse et al, ). The female preponderance of migraine has been recognized since ancient times (Welch et al, ) and has been supported by multiple areas of research.…”

Genetics of Migraine: Insights into the Molecular Basis of Migraine Disorders

“…Overall, MO and MA sufferers account for ∼70% and 20‐30% of migraineurs, respectively. ICHD‐III also describes other migraine subtypes: chronic migraine is diagnosed in patients who experience frequent or almost continuous migraine symptoms, and is often linked with medication overuse; more than 50% of females suffering from MO report a menstrual association, which has led to the further classification of menstrual migraine; and hemiplegic migraine (HM) is a rare severe form of MA that also features motor weakness.…”