Objective:

To estimate the prevalence of menstrual migraine (MM) and describe characteristics of women with MM.

Background:

MM prevalence ranges from 10-to-70% depending on the population studied and there is a lack of evidence on current treatments.

Design/Methods:

This retrospective cross-sectional study used the 2021 US National Health and Wellness Survey (NHWS, Cerner Enviza) and captured women with diagnosed migraine who reported their migraines were associated with menses. MM prevalence was calculated among all women and among pre-menopausal women (18-39 years-old or 40-55 years-old with regular or irregular menstrual bleeding). Respondents reported their current migraine treatments, migraine frequency, and disability via The Migraine Disability Assessment Test (MIDAS).

Results:

Over 19.8 million women with diagnosed migraine were represented by the weighted survey and 11.8 million were pre-menopausal. MM was reported by 6.2 million women, with a prevalence of 31.0% among all women and 52.5% among pre-menopausal women. The mean age of women with MM was 33.2±9.5 years, 52.6% were married/partnered, 66.6% were employed, and 38.2% were obese. The reported monthly migraine attack frequency was 4.5±6.5 and monthly migraine headache days were 8.4±7.4 days on average. The mean MIDAS score was 24.8±34.8 and 56.2% had moderate-to-severe migraine-specific disability. Treatments among women with MM included 42.4% using only over-the-counter medications and 48.6% using prescription medications. Among these, 63.9% reported only acute migraine treatments and 21.1% reported any use of migraine prevention. The most common acute treatments were triptans (36.7%; 3.9±5.2 days of use), non-steroidal anti-inflammatory drugs (31.1%; 8.1±8.2 days), and opioids (22.2%; 7.9±8.4 days).

Conclusions:

The prevalence of MM 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%).