Sexual dysfunction is underrecognized in patients with migraine: A systematic review and meta-analysis

This study aimed to summarize and pool the existing observational evidence on sexual dysfunction (SD) in patients with migraine and to explore sex-specific associations.

SD appears to be more common in patients with migraine, yet the available data are heterogeneous and scattered, with most research focused on women. A comprehensive synthesis across both sexes has been lacking.

This systematic review and meta-analysis of observational studies identified relevant studies reporting data on SD published between July 1987 and July 2025 were identified through searches in PubMed, Scopus, Embase, the Cochrane Library, and Google Scholar.

Twenty-one studies including 1692 patients with migraine and 741 controls were identified; nine studies were qualified for quantitative analysis. Reported SD prevalence ranged from 41.8% to 91.0% among women and from 46.6% to 80.0% among men. Across controlled studies, patients with migraine showed a higher likelihood of experiencing SD compared with healthy controls (odds ratio [OR], 6.13; 95% confidence interval [CI], 1.59-23.60). In women, the likelihood of SD was more than three times higher (OR, 3.65; 95% CI, 1.22-10.9). Data for men were limited to two small, controlled studies, both indicating higher SD rates among male patients with migraine (OR, 164.85; 95% CI, 21.09-1288.89). When studies with extreme values were excluded, the association between migraine and SD remained still elevated.

SD is common among patients with migraine, affecting both sexes, although the evidence base remains substantially richer for women. Although pooled data confirm an elevated risk of SD in women, findings in men rely on limited evidence. These results underline the need to routinely address sexual health in migraine care and highlight the urgent need for well-designed, sex-inclusive studies.