Research Finds Migraine History Associated With More Severe Hot Flashes

New research presented at the North American Menopause Society (NAMS) Annual Meeting confirms an association between history of migraine and menopausal vasomotor symptoms (VMS; hot flashes) presence and severity among midlife women. The meeting is taking place in Washington, DC, between September 22 and 25, 2021.

In addition, results of the cross-sectional questionnaire-based study suggest that neovascular dysregulation may explain the link between the 2 conditions and between VMS and migraine with cardiovascular disease (CVD) risk, respectively.

As approximately 20% of women are affected by migraine and women tend to experience more migraine-related symptoms and disability compared with men, is it believed hormones play a significant role in triggering attacks.

“Migraine is also associated with cardiovascular events and mortality in women. Similarly, VMS appear to be a biomarker of CVD risk,” authors wrote. Past research revealed that a history of migraine predicted an increased frequency of VMS in women during the menopause transition, they added.

To better understand the potential link between a history of migraine and VMS, researchers conducted a cross-sectional analysis using data from the Data Registry on the Experiences of Aging, Menopause and Sexuality (DREAMS). All participants who presented to women’s clinics at 3 US Mayo Clinic locations between May 2015 and December 2019 completed questionnaires at the time of visit.

A total of 3308 women between ages 45 and 60 were included in the analyses, of whom 895 (27%) reported a history of migraine. Mean participant age was 52.8 years, and the majority were White, has at least some college education, employed, partnered, and post menopausal.

Adjusted analyses revealed:

• Women with a history of migraine had significantly higher total Menopause Rating Scale (MRS) scores (estimated difference, 1.36; 95% CI, 0.88-1.85; P < .001), and were more likely to have severe/very severe hot flashes vs no hot flashes (odds ratio, 1.40; 95% CI, 1.05-1.86; P = .021), compared with women without migraine history.
• Odds of reporting more severe hot flashes increased monotonically in women with a history of migraine.
• Women with low back pain had higher MRS scores, but were no more likely to have severe/very severe hot flashes than those without back pain, confirming the specificity of the link between VMS and migraine.

“We believe that neurovascular dysregulation may explain the link between migraines and hot flashes, as well as the association of each with cardiovascular disease in women,” said Stephanie Faubion, MD, MBA, medical director of NAMS and the lead author of the study.

“Given the high prevalence of migraine in women, this association may help identify women who are at risk for more severe hot flashes in midlife. Further study is needed to determine whether the combination of migraine history and hot flashes in midlife predict greater heart disease risk than either alone and whether these female-specific factors could be used to enhance the accuracy of CVD risk calculations for women,” she concluded.

Reference

Faubion S, Smith T, Thielen J, et al. Does migraine associate with vasomotor symptoms? Presented at: The North American Menopause Society Annual Meeting; September 22-25, 2021; Washington, DC.