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Women's issues of migraine in tertiary care.
Headache. 2004 Jan; 44(1):2-7.H

Abstract

OBJECTIVES

To document the frequency and types of symptoms of migraine in a large group of female migraineurs in tertiary care. Background.-Hormonal changes remain a significant accompaniment in the life cycle of the female migraineur. Little is documented on the relationship of women's issues to other features of migraine or to the lives of patients with migraine. Successful management of migraine mandates attention to women's issues from menarche to beyond menopause. The more information available to this end, the more confidently the clinician can prognosticate, guide, and treat the female patient.

METHODS

Women's issues were evaluated in 504 women with migraine diagnosed according to the criteria of the International Headache Society (codes 1.1 and 1.2). The variables graded on a scale of 0 to 3 at the initial visit included premenstrual syndrome, menopausal symptoms, use of birth control pills, use of hormone replacement therapy, hormonal triggering of headaches, worsening of headaches with birth control pills or hormone replacement therapy, headaches with menses only, headaches with menses and at other times, headaches in pregnancy, headaches unchanged in pregnancy, headaches worse in pregnancy, and headaches better in pregnancy. These variables were stratified by age and headache diagnosis.

RESULTS

Premenstrual syndrome was reported in 68.7% of patients, menopausal symptoms in 29.0%, and headaches attributed to birth control pills or hormone replacement therapy in 24.4% of patients. Sixty-four point nine percent of women had headaches with menses as well as at other times, while 3.4% of women had headaches exclusively with menses. A pregnancy was reported in 61.3% of the women; 20.4% did not experience headache in pregnancy. Of the 79.6% who did experience headache, 17.8% reported that headaches improved in pregnancy, 27.8% reported headaches to be unchanged, and 34% reported a worsening of headaches. Hormone replacement therapy or birth control pills triggered headaches in 64% of the study group. Patients with 100% aura were significantly different from patients with 0% aura, being less likely to have headaches worsening with birth control pills or hormone replacement therapy (P <.01) and more likely to have headaches occurring during pregnancy (P <.05). When patients with 100% aura were matched for age, headache frequency, use of birth control pills or hormone replacement therapy, and use of prophylactic medications with patients having 0% aura, the former were significantly less likely to have menopausal symptoms (P <.05), less likely to have headaches worsening with birth control pills or hormone replacement therapy (P <.01), and more likely to have headaches occurring only during pregnancy (P <.05).

CONCLUSIONS

This study provides a documentation of women's issues in a large cohort of patients. Stratification by headache type, presence of aura, and age refine the study.

Authors+Show Affiliations

Headache Center of Atlanta, GA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14979877

Citation

Kelman, Leslie. "Women's Issues of Migraine in Tertiary Care." Headache, vol. 44, no. 1, 2004, pp. 2-7.
Kelman L. Women's issues of migraine in tertiary care. Headache. 2004;44(1):2-7.
Kelman, L. (2004). Women's issues of migraine in tertiary care. Headache, 44(1), 2-7.
Kelman L. Women's Issues of Migraine in Tertiary Care. Headache. 2004;44(1):2-7. PubMed PMID: 14979877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Women's issues of migraine in tertiary care. A1 - Kelman,Leslie, PY - 2004/2/26/pubmed PY - 2004/4/2/medline PY - 2004/2/26/entrez SP - 2 EP - 7 JF - Headache JO - Headache VL - 44 IS - 1 N2 - OBJECTIVES: To document the frequency and types of symptoms of migraine in a large group of female migraineurs in tertiary care. Background.-Hormonal changes remain a significant accompaniment in the life cycle of the female migraineur. Little is documented on the relationship of women's issues to other features of migraine or to the lives of patients with migraine. Successful management of migraine mandates attention to women's issues from menarche to beyond menopause. The more information available to this end, the more confidently the clinician can prognosticate, guide, and treat the female patient. METHODS: Women's issues were evaluated in 504 women with migraine diagnosed according to the criteria of the International Headache Society (codes 1.1 and 1.2). The variables graded on a scale of 0 to 3 at the initial visit included premenstrual syndrome, menopausal symptoms, use of birth control pills, use of hormone replacement therapy, hormonal triggering of headaches, worsening of headaches with birth control pills or hormone replacement therapy, headaches with menses only, headaches with menses and at other times, headaches in pregnancy, headaches unchanged in pregnancy, headaches worse in pregnancy, and headaches better in pregnancy. These variables were stratified by age and headache diagnosis. RESULTS: Premenstrual syndrome was reported in 68.7% of patients, menopausal symptoms in 29.0%, and headaches attributed to birth control pills or hormone replacement therapy in 24.4% of patients. Sixty-four point nine percent of women had headaches with menses as well as at other times, while 3.4% of women had headaches exclusively with menses. A pregnancy was reported in 61.3% of the women; 20.4% did not experience headache in pregnancy. Of the 79.6% who did experience headache, 17.8% reported that headaches improved in pregnancy, 27.8% reported headaches to be unchanged, and 34% reported a worsening of headaches. Hormone replacement therapy or birth control pills triggered headaches in 64% of the study group. Patients with 100% aura were significantly different from patients with 0% aura, being less likely to have headaches worsening with birth control pills or hormone replacement therapy (P <.01) and more likely to have headaches occurring during pregnancy (P <.05). When patients with 100% aura were matched for age, headache frequency, use of birth control pills or hormone replacement therapy, and use of prophylactic medications with patients having 0% aura, the former were significantly less likely to have menopausal symptoms (P <.05), less likely to have headaches worsening with birth control pills or hormone replacement therapy (P <.01), and more likely to have headaches occurring only during pregnancy (P <.05). CONCLUSIONS: This study provides a documentation of women's issues in a large cohort of patients. Stratification by headache type, presence of aura, and age refine the study. SN - 0017-8748 UR - https://www.unboundmedicine.com/medline/citation/14979877/Women's_issues_of_migraine_in_tertiary_care_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0017-8748&amp;date=2004&amp;volume=44&amp;issue=1&amp;spage=2 DB - PRIME DP - Unbound Medicine ER -