Most women with menstrual migraine use acute treatments only

Key takeaways:

• Among women with menstrual migraine, 63.9% reported only using acute migraine treatments.
• The most common acute treatments were triptans, NSAIDs and opioids.

DENVER – Most with menstrual migraine utilize only acute treatments, rather than preventive measures, to address their symptoms, according to research presented at the American Academy of Neurology annual meeting.

“[Menstrual migraine] prevalence ranges from 10% to 70% depending on the population studied and there is a lack of evidence on current treatments,” Jessica Cirillo, MHS, director of Value and Evidence Migraine at Pfizer, and colleagues wrote.

Cirillo and colleagues sought to estimate the prevalence of menstrual migraine (MM) and to describe characteristics of women with the condition.

Their retrospective cross-sectional study culled data from the 2021 U.S. National Health and Wellness Survey, which included more than 19.8 million women, 11.8 million of who were pre-menopausal. From that initial set, 6.2 million women (mean age, 33.2±9.5 years; 52.6% were married/partnered) had diagnosed migraine and additionally reported that their migraines were associated with menses.

Prevalence of migraine was calculated among all women as well as among pre-menopausal women (aged 18 to 39 years or 40 to 55 years with regular or irregular menstrual bleeding). All participants reported their current migraine treatments, migraine frequency and disability via the Migraine Disability Assessment Test (MIDAS), where scores of 0 to 5 indicate either no disability or limited disability and scores of 21 and higher indicate the most severe disability.

Among all participants, monthly average migraine attack frequency was 4.5±6.5 and monthly migraine headache days were 8.4±7.4.

The mean MIDAS score was 24.8±34.8 and 56.2% of respondents recorded moderate to severe migraine-specific disability.

The researchers found that 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 type of preventative measures. The most common acute treatments were triptans (36.7%; 3.9±5.2 days of use), NSAIDs (31.1%; 8.1±8.2 days) and opioids (22.2%; 7.9±8.4 days).

“The prevalence of [menstrual migraine] was 31% to 52% among women and more than half of women with MM reported moderate-to-severe disability associated with their migraines,” Cirillo and colleagues wrote. “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%).”