Migraine is the second-leading cause of disability worldwide and affects roughly 1.1 billion people. In the United States, 39 million people live with migraine and lose an average of 4 to 6 workdays per year to attacks. Women are affected at 3 times the rate of men. The average diagnostic delay is 5 to 7 years, and only 26 to 47% of people with migraine receive adequate treatment. These are not abstract numbers. They describe a public health failure on the scale of asthma and diabetes that gets a fraction of the attention.

If you have ever felt that the medical system underestimates your migraines, the data backs you up. Here is the picture in numbers.

Prevalence

  • 1.1 billion: people worldwide living with migraine (Global Burden of Disease Study, 2021)
  • 39 million: Americans with migraine, including 6.7 million with chronic migraine
  • 12%: adult prevalence in the United States
  • 17%: female adult prevalence
  • 6%: male adult prevalence
  • 10%: children and adolescents affected

Migraine is more common than diabetes, epilepsy, and asthma combined.

The gender gap

  • 3 to 1: female-to-male ratio after puberty
  • 1 to 1: ratio before puberty, when boys and girls are affected equally
  • 60%: portion of female patients whose attacks cluster around their menstrual cycle. See our hormonal migraine calendar.
  • Up to 40%: increase in attack frequency during perimenopause

The gap opens at puberty and closes in late life as estrogen exposure decreases. This is one of the cleanest hormone-disease relationships in all of medicine. See perimenopause migraine changes.

Disability and economic impact

  • Second: migraine's global rank as a cause of years lived with disability (only low back pain is higher)
  • First: rank as a cause of disability for women under 50 worldwide
  • $36 billion: annual direct and indirect cost of migraine in the United States
  • $13 billion: portion attributable to lost productivity and absenteeism
  • 113 million: workdays lost annually in the US
  • 4 to 6: average workdays lost per person per year, much higher in chronic migraine
  • 70%: of people with migraine who report reduced productivity at work during attacks (presenteeism)

For more on working with chronic migraine, see chronic migraine working 9 to 5.

The diagnostic and treatment gap

  • 5 to 7 years: average delay between first attack and accurate diagnosis
  • 50%: people with migraine who have never received a formal diagnosis
  • 26 to 47%: portion of diagnosed patients on appropriate acute treatment
  • 3 to 13%: portion of eligible patients receiving any preventive treatment
  • 88%: of people who self-diagnose "sinus headache" who actually meet full migraine criteria

The data is consistent across countries. Most people with migraine never see a neurologist. Of those who do, fewer than half leave with a treatment plan that matches current guidelines.

Chronic migraine specifics

  • 15+: headache days per month required for a chronic migraine diagnosis (8+ must be migrainous)
  • 2.5%: of people with episodic migraine who progress to chronic migraine each year
  • 3 to 5x: increased disability of chronic vs episodic migraine
  • 4x: increased depression comorbidity in chronic migraine
  • 2.5x: increased anxiety comorbidity

See migraine and depression connection and anxiety and chronic headaches.

Treatment effectiveness

  • 50 to 60%: of patients achieve sustained pain freedom with early triptan use
  • 40 to 60%: response rate to CGRP monoclonal antibodies for prevention
  • 50%: attack reduction with onabotulinumtoxinA in chronic migraine (PREEMPT trial)
  • 30 to 50%: of people who try a preventive medication abandon it within 6 months due to side effects or perceived ineffectiveness

The drugs work. Adherence and access are the bottlenecks. See CGRP inhibitors what to know.

Triggers, by frequency reported

  • Stress: 70 to 80% of patients
  • Sleep changes: 50 to 70%
  • Hormonal changes: 65% of menstruating people
  • Weather and barometric pressure: 50 to 65%. See barometric pressure migraines.
  • Skipped meals: 40 to 60%
  • Bright or flickering light: 40 to 55%
  • Strong odors: 35 to 50%
  • Alcohol: 30 to 40%
  • Specific foods: 10 to 30% (lower than commonly believed)

For more on how triggers actually work, see trigger stacking.

The takeaway

These numbers do not just describe a disease. They describe a system that consistently underestimates a condition that is more common than diabetes, more disabling than nearly any other chronic illness for working-age adults, and entirely treatable for most patients with the right plan. The first step out of the statistic is data: track your attacks, find your patterns, and bring the evidence to your clinician.

Sources

  • GBD 2021 Headache Collaborators. "Global, Regional, and National Burden of Migraine, 1990-2021." Lancet Neurology, 2024.
  • Burch RC et al. "Migraine: Epidemiology, Burden, and Comorbidity." Neurologic Clinics, 2019.
  • Lipton RB et al. "Migraine in America Symptoms and Treatment (MAST) Study." Headache, 2018.
  • Steiner TJ et al. "Migraine Remains Second Among the World's Causes of Disability." Journal of Headache and Pain, 2018.
  • Buse DC et al. "Chronic Migraine Prevalence, Disability, and Sociodemographic Factors." Headache, 2012.