Women’s Health
Association of migraine and vasomotor symptom severity and duration in midlife in Nurses’ Health Study 2 Holly Crowe* Holly Crowe Janet Rich-Edwards Kathryn Rexrode Hadine Joffe
Objective: Migraine and vasomotor symptoms (VMS) are prevalent brain conditions linked to female sex hormones and negatively impact quality of life for middle-aged women. We aimed to quantify the association between migraine phenotype and VMS severity and duration across the final menstrual period.
Methods: We analyzed data from 21,648 participants in Nurses’ Health Study II, an ongoing prospective cohort study of female registered nurses aged 25-42 at baseline in 1989. We included individuals who were within 2 years before or after self-reported cessation of menses from 2007-2015. We analyzed their self-reported migraine and VMS from 2009-2017, stratifying by history of clinician-diagnosed migraine and migraine phenotype (with and without aura) and estimated the cross-sectional association between migraine and VMS in midlife using logistic regression, adjusting for demographic, lifestyle, and reproductive health factors.
Results: Overall, 64% of the cohort reported VMS in the past four weeks (4% severe VMS) and 36% reported VMS lasting ≥5 years. Individuals with recent (past two years) migraine in midlife (29%) had 25% (17%-34%) greater odds of reporting VMS than those without migraine. Recent midlife migraine was also associated with severe (OR=1.45, 95% CI=1.25-1.69) and prolonged (≥5 years; OR=1.18, 95% CI=1.08-1.29) VMS. Migraine with aura and clinician-diagnosed migraine were more strongly associated with severe VMS than was migraine without aura or self-reported migraine. VMS duration did not materially differ across migraine phenotypes.
Discussion: While the nature of the association remains unclear, our findings highlight the importance of risk assessment and screening for VMS among women with migraine.
