Association of migraine and vasomotor symptom severity and duration among naturally menopausal women in Nurses' Health Study II.

Objective: Migraine and vasomotor symptoms (VMS) are prevalent brain conditions linked to female sex hormones and negatively impact the 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 21,468 participants in Nurses' Health Study II, an ongoing prospective cohort study of female registered nurses aged 25-42 at baseline in 1989. We included naturally menopausal individuals who reported a final menstrual period from 2007 through 2015. We analyzed the cross-sectional association between self-reported migraine headaches (with and without self-reported clinician diagnosis) and migraine phenotype (with and without aura) 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 4 weeks. Of those experiencing VMS, 7% reported severe VMS and 31% reported VMS lasting ≥5 years. Individuals with recent (past 2 y) migraine in midlife (29%) had 30% (21%-40%) greater odds of reporting VMS than those without migraine (68% of women vs 63%). Among women reporting VMS, recent midlife migraine (vs no recent migraine) was also associated with severe (8% vs 6%, OR = 1.53, 95% CI = 1.30-1.81) and prolonged (35% vs 30% ≥5 years; OR = 1.24, 95% CI = 1.12-1.36) VMS. Although migraine phenotype was unassociated with VMS frequency or duration, migraine with aura and self-reported clinician-diagnosed migraine were more strongly associated with severe VMS than were migraine without aura or self-reported migraine.

Conclusion: While the nature of the association remains unclear, our findings highlight the importance of risk assessment and screening for VMS among women with migraine.