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Women’s Issues of Migraine in Tertiary Care
Leslie Kelman, MD
Posted: March 2004  
Headache 2004;44:2-7

Objective:   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. 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.

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.