Shuang Li, Jianhua Zhang

Department of Neurology, Shangyu People’s Hospital of Shaoxing, Shaoxing University, Zhejiang, People’s Republic of China

Correspondence: Jianhua Zhang, Department of Neurology, Shangyu People’s Hospital of Shaoxing, Shaoxing University, 517 Baiguan Road, Shangyu District, Zhejiang, 312300, People’s Republic of China, Email wahdr1979@163.com Shuang Li, Department of Neurology, Shangyu People’s Hospital of Shaoxing, Shaoxing University, 517 Baiguan Road, Shangyu District, Zhejiang, 312300, People’s Republic of China, Email shuangkiera666@outlook.com

Objective: To investigate whether menopausal status modifies the association between magnesium intake and migraine in women, hypothesizing that hormonal differences between pre-menopausal and post-menopausal women would result in differential responses to magnesium intake.
Background: While magnesium’s role in migraine management has gained attention, the relationship between magnesium intake and migraine across menopausal status remains poorly studied. This is the first study to compare this association between pre-menopausal and post-menopausal women specifically.
Methods: This cross-sectional study analyzed 3,248 women from the National Health and Nutrition Examination Survey (1999– 2004), which achieved interview response rates of 79– 84%. Menopausal status was determined by self-report: pre-menopausal (n=1,412) or post-menopausal (n=1,836). The exposure variable was total magnesium intake (dietary plus supplements); the outcome was self-reported migraine. Covariates included age, race, education, income, body mass index, smoking, drinking, hypertension, diabetes, C-reactive protein, estimated glomerular filtration rate, and calcium intake. Non-linear relationships were examined using piecewise logistic regression.
Results: Migraine prevalence was higher in pre-menopausal (31.3%) than post-menopausal women (15.6%). A significant non-linear relationship between magnesium intake and migraine was observed in pre-menopausal women, with odds of migraine decreasing by 36.0% per unit increase in magnesium intake below 325.41 mg/day (OR: 0.64, 95% CI: 0.42– 0.98, P=0.042), with no significant association above the threshold. No significant association was found in post-menopausal women. Supplementary weighted analysis validated these findings.
Conclusion: Menopausal status may modify the relationship between magnesium intake and migraine. Adequate magnesium intake may be beneficial for reducing migraine risk in pre-menopausal women. Given that over half of American adults fail to meet recommended magnesium intake, these findings have significant public health implications for targeted dietary interventions in reproductive-age women, though prospective validation is needed.

Keywords: magnesium intake, migraine, menopause, National Health and Nutrition Examination Survey, cross-sectional study