Menstrual Cycle and Headache in Teenagers
- 10 Downloads
This population-based study on school-aged girls aimed to estimate the rate of peri-menstrual headache, evaluate headache pain pattern during the menstrual cycle, and verify its relationships with physical, psychosocial and life-style factors.
The students (n = 4973) fulfilled a self-administered questionnaire on demographic and behavioral characteristics, menarche, menstrual pattern and features including headache and dysmenorrhea. The prevalence of headache and the mean pain intensity score at the three menstrual cycle phases (premenstrual, menstrual, in-between period) were estimated, both overall and by gynecological year. Furthermore, the prevalence of three different patterns of headache (peri menstrual/mid-cycle/acyclic) was evaluated, together with the mean pain intensity score.
The overall prevalence of headache at least once at any time during the menstrual cycle was 64.4%. At multivariable logistic analysis, gynecological age (OR 1.07; 95%CI 1.03–1.12), middle social level (1.24; 1.01–1.55, compared to high social level), physical activity (0.67; 0.51–0.89), oral contraceptive use (1.34; 1.04–1.73) and dysmenorrhea (2.30; 1.54–3.42) were significantly associated with headache. Among girls with headache, 83.4% had peri-menstrual headache (44.6% premenstrual, 38.8% menstrual), 3.5% mid-cycle headache and 13.2% acyclic headache. The gynaecological age and dysmenorrhea were significantly associated with the headache pattern (p = 0.03 and p < 0.0001, respectively).
This study suggests that peri-menstrual headache is highly prevalent among adolescents. In girls, the headache rate linearly raises with higher gynecological age; menses-related painful syndromes, such as headache and dysmenorrhea, are strongly interrelated. The anamnesis and monitoring of menstrual health should be mandatory when taking care of girls with headache.
KeywordsAdolescents. Menstrual headache Headache pattern Pain Gynecological age Dysmenorrhea
DSC: Conception and design of the study, acquisition of data, revision of the paper; DSV: Conception and design of the study, acquisition of data, interpretation of data, revision of the paper; PE: Conception of the scientific question and design of the study, analysis and interpretation of data, draft and revision of the paper; RG: Conception and design of the study, acquisition of data, interpretation of data, revision of the paper; RF: conception and design of the study, acquisition of data, interpretation of data, revision of the paper.
BL: Conception of the scientific question and design of the study, analysis and interpretation of data, draft and revision of the paper; BM: Conception and design of the study, acquisition of data, interpretation of data, revision of the paper; BPA: Conception of the scientific question, revision of the paper; BS, BG, BF and TG: Conception and design of the study, acquisition of data, interpretation of data and revision of the paper. PE will act as guarantor for this paper.
Compliance with Ethical Standards
Conflict of Interest
Source of Funding
- 1.Buse DC, Loder EW, Gorman JA, et al. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American migraine prevalence and prevention (AMPP) study. Headache. 2013;53:1278–99.Google Scholar
- 5.Crawford MJ, Lehman L, Slater S, et al. Menstrual migraine in adolescents. Headache. 2009;49:341–7.Google Scholar
- 11.Bellini B, Arruda M, Cescut A, et al. Headache and comorbidity in children and adolescents. J Headache Pain. 2013;14:79.Google Scholar
- 22.Rigon F, Bianchin L, Bernasconi S, et al. Update on age at menarche in Italy: toward the leveling off of the secular trend. J Adolesc Health. 2010;46:238–44.Google Scholar
- 27.Dzoljic E, Sipetic S, Vlajinac H, et al. Prevalence of menstrually related migraine and nonmigraine primary headache in female students of Belgrade University. Headache. 2002;42:185–93.Google Scholar
- 32.Martin VT, Wernke S, Mandell K, et al. Defining the relationship between ovarian hormones and migraine headache. Headache. 2005;45:1190–201.Google Scholar
- 33.Sanders D, Warner P, Bȧckström T, Bancroft J. Mood, sexuality, hormones and the menstrual cycle. I. Changes in mood and physical state: description of subjects and method. Psychosomatic Med. 1982;45:481–501.Google Scholar
- 38.Oterino A, Toriello M, Cayón A, et al. Multilocus analyses reveal involvement of the ESR1, ESR2, and FSHR genes in migraine. Headache. 2008;48:1438–50.Google Scholar