Migraine Prevalence Higher Among Sexual Minority Adults

By Lisa Rapaport

September 30, 2020

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(Reuters Health) - U.S. adults who identify as lesbian, gay or bisexual are more likely to experience migraines, a new study suggests.

To assess disparities in migraine prevalence, researchers examined cross-sectional, nationally representative data on 9,894 adults with a mean age of 37.3 years who were participants in the National Longitudinal Study of Adolescent to Adult Health.

This study measured migraine exposure based on self-report of five or more headaches lasting at least four hours; one-sided, pulsating, intense, or worsened by activity; and associated with nausea, vomiting, or sensitivity to light or sound. Participants reported their sexual orientation as exclusively heterosexual (85.8%); mostly heterosexual but sometimes attracted to people of one's own sex (10%); or lesbian, gay or bisexual (4.2%).

Compared to adults who said they were exclusively heterosexual, those who reported being mostly heterosexual or who identified as lesbian, gay or bisexual were more prone to migraines (adjusted odds ratios 1.35 and 1.58).

Although prior research has identified disparities in migraine by race and sex, little was previously known about disparities in migraine by sexual orientation, said study coauthor Dr. Jason Nagata of the University of California, San Francisco.

"Lesbian, gay, and bisexual people may experience homophobia and discrimination which can lead to stress and trigger a migraine," Dr. Nagata said by email. "They may also face barriers to accessing health care, which can lead to worsened health."

Migraine prevalence was higher among those who said they were lesbian, gay or bisexual (30.7%) and those who reported being mostly heterosexual (30.3%) than among people who said they were exclusively heterosexual (19.4%), researchers report in JAMA Neurology.

One limitation of the study is the use of self-reported measures for migraine exposure, and the lack of medical records or clinician assessment to independently verify this diagnosis. Another limitation is the lack of data to differentiate between sexual identity and behavior.

The study was also underpowered to identify any differences in migraine prevalence based on specific sexual orientations.

Even so, clinicians should know that sexual and gender minorities experience migraine commonly, and should ask patients in these groups about migraine history to ensure that patients are well-informed about migraine, said Dr. H. E. Hinson, associate director of clinical research in the Neurocritical Care Program at Oregon Health & Science University in Portland.

"Prompt identification allows symptoms to be managed appropriately if migraine is present," Dr. Hinson, who wasn't involved in the study, said by email. "Even simple lifestyle modifications can make a huge difference in quality of life for migraine sufferers."

SOURCE: https://bit.ly/2S9KKlH JAMA Neurology, online September 28, 2020.