Sex differences in clinical characteristics of migraine and its burden: a population-based study

Mona Ameri Chalmer*, Lisette J.A. Kogelman, Ida Callesen, Charlotte Grønvold Christensen, Tanya Ramdal Techlo, Peter L. Møller, Olafur B. Davidsson, Isa A. Olofsson, Michael Schwinn, Susan Mikkelsen, Khoa Manh Dinh, Kaspar Nielsen, Mie Topholm, Christian Erikstrup, Sisse Rye Ostrowski, Ole Birger Pedersen, Henrik Hjalgrim, Karina Banasik, Kristoffer S. Burgdorf, Mette NyegaardJes Olesen, Thomas Folkmann Hansen, DBDS Genomic Consortium

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

14 Citations (Scopus)
14 Downloads (Pure)

Abstract

Background and purpose: Understanding migraine in a sex-specific manner is crucial for improving clinical care, diagnosis and therapy for both females and males. Here, data on sex differences are provided in the presentation of migraine in a large European-based population cohort, which is representative of the general population. Methods: A population-based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine, was performed. All participants completed a 105-item diagnostic migraine questionnaire sent via an electronic mailing system (e-Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders, third edition. Results: The migraine questionnaire was in-cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93% and a sensitivity of 93%. There were 9184 females (mean age 45.1 years) and 3434 males (mean age 48.0 years). The 3-month prevalence of migraine without aura was 11% in females and 3.59% in males. The 3-month prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age-related 3-month prevalence of migraine without aura increased markedly during childbearing age. In males, migraine both with and without aura showed less age variation. Females had a higher frequency of migraine attacks (odds ratio [OR] 1.22) but a lower frequency of non-migraine headaches (OR = 0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR = 1.40–1.49) as well as more associated symptoms (OR = 1.26–1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), whilst there was no sex difference in the disease burden of migraine with aura. Conclusion: Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone.

Original languageEnglish
JournalEuropean Journal of Neurology
Volume30
Issue number6
Pages (from-to)1774-1784
ISSN1351-5101
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Keywords

  • blood donors
  • burden
  • migraine
  • population-based study
  • sex differences
  • sex stratification

Cite this