• Necdet Karlı, Betül Baykan, Mustafa Ertaş, Mehmet Zarifoğlu, Aksel Siva, Sabahattin Saip, Güven Ozkaya, Turkish Headache Prevalence Study Group, and Ayşe Emel Onal.
• Department of Neurology, School of Medicine, University of Uludağ, 16059, Bursa, Turkey. nkarli@yahoo.com
• J Headache Pain. 2012 Oct 1; 13 (7): 557565557-65.

AbstractSex hormones have some implications on headaches. The objective of the study was to investigate the effects of hormonal changes comparatively on tension-type headache (TTH) and migraine, in a population-based sample. A nationwide face-to-face prevalence study was conducted using a structured electronic questionnaire. 54.3 % of the migraineurs reported that the probability of experiencing headache during menstruation was high, whereas 3.9 % had headache only during menstruation. Forward logistic regression analysis revealed that menstruation was a significant trigger for migraine in comparison to TTH. On the other hand, nearly double the number of TTH sufferers reported "pure menstrual headache" compared to migraineurs (p = 0.02). Menstrual headaches caused significantly higher MIDAS grades. One-third of the definite migraineurs reported improvement during pregnancy and oral contraceptives significantly worsened migraine. Menopause had a slight improving effect on migraine compared to TTH. Sex hormonal changes have major impacts particularly on migraine; however, the effects of hormonal fluctuations on TTH should not be underestimated.

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