{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:43:23Z","timestamp":1786445003338,"version":"build-2736575974"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>There is a need for better recognition and more extensive research into menstrual migraine (MM) in the general population, and a revision of the diagnostic criteria for MM is warranted to move the field forward. Increased understanding of MM is crucial for improving clinical care, diagnosis, and therapy for MM.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To assess the clinical characteristics of MM, including severity and treatment response, and to propose new diagnostic criteria for pure MM and menstrually related migraine.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This is a case-control study of Danish individuals with migraine. All individuals completed a 105-item validated diagnostic migraine questionnaire, sent via the Danish electronic mailing system (e-Boks) between May and August 2020, allowing diagnosis of pure MM and menstrually related migraine by the International Classification of Headache Disorders, Third Edition<\/jats:italic> (ICHD-3<\/jats:italic>). Data analysis was performed from September 2021 to November 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Diagnosis of migraine.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Clinical characteristics of women with MM and women with nonmenstrual migraine (non-MM) were compared using the ICHD-3 <\/jats:italic>diagnostic criteria. A simulation of the risk of randomly misclassifying MM was based on number of migraine attacks during 3 menstrual cycles (3\u2009\u00d7\u200928 days), and simulation analyses were performed using 100\u202f000 permutations of random migraine attacks in migraine patients.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 12\u202f618 individuals, including 9184 women, with migraine participated in the study. Among the women with migraine, the prevalence of MM was 16.6% (1532 women), and the prevalence of non-MM was 45.9% (4216 women). The mean (SD) age was 38.7 (8.7) years for women with MM and 37.0 (9.2) years for women with non-MM. Of the 1532 women with MM, 410 (26.8%) fulfilled ICHD-3<\/jats:italic> diagnostic criteria for pure MM, 1037 (67.7%) fulfilled ICHD-3<\/jats:italic> diagnostic criteria for menstrually related migraine, and 152 (9.9%) fulfilled proposed diagnostic criteria for rare pure MM. MM was associated with a higher frequency of migraine-accompanying symptoms (odds ratio [OR], 1.98; 95% CI, 1.71-2.29), more frequent (OR, 7.21; 95% CI, 5.77-9.03) and more severe (OR, 1.17; 95% CI, 1.13-1.21) migraine attacks, lower frequency of nonmigraine headache (OR, 0.31; 95% CI, 0.18-0.49), an overall greater response to treatment with triptans (OR, 1.66; 95% CI, 1.24-2.24), better improvement of migraine attacks during late pregnancy (OR, 5.10; 95% CI, 2.17-14.00), and faster reappearance of migraine attacks post partum (OR, 3.19; 95% CI, 2.40-4.25). Hormonal contraceptive\u2013related MM was associated with a higher prevalence of migraine without aura than migraine related to spontaneous menstruation (OR, 1.82; 95% CI, 1.62-2.06). Otherwise, no differences between hormonal and spontaneous MM were observed. The risk of random diagnostic misclassification of ICHD-3<\/jats:italic> menstrually related migraine in women with high frequency episodic migraine was 43%. This risk was reduced to 3% when applying the proposed criteria for menstrually related migraine.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this case-control study, MM in the general population had clinical characteristics that were quantitively different from those of non-MM. Detailed descriptive data and suggested improved diagnostic criteria for pure MM and menstrually related migraine were provided.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.13235","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T15:38:05Z","timestamp":1684165085000},"page":"e2313235","source":"Crossref","is-referenced-by-count":29,"title":["Population-Based Characterization of Menstrual Migraine and Proposed Diagnostic Criteria"],"prefix":"10.1001","volume":"6","author":[{"given":"Mona Ameri","family":"Chalmer","sequence":"first","affiliation":[{"name":"Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette J. A.","family":"Kogelman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Ullum","sequence":"additional","affiliation":[{"name":"Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Didriksen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Mikkelsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoa Manh","family":"Dinh","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Brodersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Zealand University Hospital, K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaspar R.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mie Topholm","family":"Bruun","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Banasik","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Brunak","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Erikstrup","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole Birger","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Zealand University Hospital, K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisse Rye","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Folkmann","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark"},{"name":"Novo 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