Iris Verhagen (Leiden/ NL; Rotterdam/ NL), Britt van der Arend (Leiden/ NL; Rotterdam/ NL), Daphne van Casteren (Leiden/ NL), Saskia Le Cessie (Leiden/ NL), Antoinette Maassen van den Brink (Rotterdam/ NL), Gisela Terwindt (Leiden/ NL)
Abstract text (incl. figure legends and references)
Background Women retrospectively report longer migraine attacks and more accompanying symptoms than men, but this has not been confirmed in longitudinal studies (1). Supposed differences could result from more refractory perimenstrual migraine attacks, or migraine attacks in women in general could be associated with different characteristics.
Methods We assessed differences in migraine attack characteristics between men and women, who were prospectively followed with previously validated E-diaries at the Leiden Headache Center. The primary outcome was attack duration. Secondary outcomes comprised recurrence risk and prevalence of accompanying symptoms. Differences between men and women were assessed with linear and logistic models using GEE, corrected for chronic migraine, medication-overuse headache and age dichotomized at 50 as a proxy for menopause.
Results A total of 1,347 women and 284 men were included. Both perimenstrual (62% (47-79%), p<0.001) and non-perimenstrual (15% (5-25%), p=0.03) migraine attacks had longer duration than migraine attacks in men. Recurrence risk was greater for perimenstrual (OR (95%CI): 2.39 (1.93-2.95), p<0.001), but not for non-perimenstrual (1.18 (0.97-1.45), p=0.06) attacks. Migraine attacks in women in general were more often accompanied by photophobia, phonophobia and nausea, but less often by aura symptoms.
Conclusion Not only perimenstrual, but also non-perimenstrual migraine attacks have longer duration than migraine attacks in men, although to a lesser extent. In general, women more often experience accompanying symptoms than men. These results highlight the need for sex-specific approaches in migraine treatment and research.
Buse DC, Loder EW, Gorman JA, et al. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache 2013;53:1278-1299.