Sex Differences in Prevalence, Symptoms, Impact, and Psychiatric Comorbidities in Migraine and Probable Migraine: A Population-Based Study

Objective: This study was conducted to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population-based sample.

Background: While there is research on sex differences in clinical characteristics and their impact on migraine headache, only few studies have investigated sex differences in probable migraine in population-based settings. Moreover, compared with Western countries, the prevalence of probable migraine in Asia is relatively high. This cross-sectional study was designed to investigate sex differences in the prevalence and clinical presentation of migraine and probable migraine in a general population-based sample.

Methods: We used the data of the Korean Headache-Sleep Study, which is a nationwide survey on headache and sleep.

Results: We interviewed 7430 people, and 3114 of them agreed to participate in our study (rejection rate, 58.1%). Among these people, 419 withdrew their participation during the interview. Ultimately, 2695 people completed our survey (cooperation rate, 36.3%). The prevalence of overall migraine and probable migraine was 350/1350 (25.9%) for women and 172/1345 (12.8%) for men (P < .001, respectively). The prevalence of migraine (107/1350 [7.9%] vs 36/1345 [2.7%], P < .001) and probable migraine (243/1350 [18.0%] vs 136/1345 [10.1%], P < .001) was significantly higher among women than among men. Headache frequency per month (median [interquartile range]) (1.0 [0.3-3.0] vs 0.8 [0.3-2.0], P = .037), the visual analog scale score for headache intensity (5.0 [4.0-7.0] vs 5.0 [3.0-6.0], P = .019), and the impact of headache {Headache Impact Test-6 score (47.0 [42.0-54.0] vs 44.0 [42.0-51.8], P = .013)} were significantly higher among women with probable migraine than men. Headache frequency per month (2.0 [0.4-4.0] vs 1.0 [0.3-2.0], P = .073), headache intensity (6.0 [5.0-8.0] vs 6.0 [4.2-7.0], P = .281), and the impact of headache (55.0 [48.0-61.0] vs 49.0 [46.3-60.8], P = .225) were not significantly different between women and men with migraine. Other comorbidities or associated symptoms, such as anxiety and depression, were not significantly different between women and men with migraine and probable migraine, except for nausea in probable migraine.

Conclusion: Women experience more severe symptoms and a higher impact of headache than men among participants with probable migraine. Our findings suggest that women with PM need a more intensive evaluation and treatment than men with PM.