Iron Deficiency Anemia Is Associated with Menstrual Migraine: A Case–Control Study

Abstract

OBJECTIVE: Association between iron deficiency anemia (IDA) and migraine, its subgroups, or tension-type headache (TTH) has not yet been shown. This study aimed to determine whether there was an association between IDA and these disorders. DESIGN: Case-control study. SETTING: Gebze Fatih General Hospital, Kocaeli, Turkey. SUBJECTS: Migraine and TTH patients, as well as healthy controls (N = 170/group), were investigated. METHODS: Descriptive statistics and multivariate logistic regression analyses were performed. Migraine and TTH groups (that included both sexes) and specific migraine subtypes (females only) were selected as dependent variables with sex, age, family history of migraine, alcohol consumption, cigarette smoking, and IDA selected as independent variables. The migraine subgroups selected were as follows: (1) pure menstrual migraine (PMM) or menstrually related migraine (MRM) and (2) migraine not associated with menses (MNAM). RESULTS: IDA was more common in patients with migraine than controls (21.7% vs 12.9%, P = 0.02). There was no association between IDA and TTH (15.9% vs 12.9%, P = 0.43). Family history of migraine (P < 0.001) and IDA (P = 0.03) were significant factors in the model of migraine. Age (P = 0.009), family history of migraine (P < 0.001), and IDA (P = 0.018) were significant factors in the model of PMM/MRM. Only family history of migraine (P < 0.001) was significant in the model of MNAM. CONCLUSIONS: Our findings indicate that IDA is significantly associated with PMM/MRM. Further research may determine whether the complex relationships between estrogen, iron metabolism, and dopamine dysfunction, and their effects on migraine, are underlying reasons for this association.