The Frequency and Pattern of Headache in Menopausal Women

Abstract

Objective To assess the frequency and pattern of headache in perimenopausal women. Study design A questionnaire survey performed on 200 consecutive women attending Leicester Royal Infirmary menopause clinic during May 1997. Main outcome measures The main areas considered included frequency, duration and severity of headache, type and effectiveness of treatment used, interference with daily activities, and the effect of menopause and HRT on headache. Results 38 women (19%) never experienced headaches whereas 158 (79%) reported recurrent headaches. The majority of these women (106) reported at least one headache in the preceding week with a small number (9) reporting daily headache. Stress (106), tiredness (75) and menstrual cycle (54) were common trigger factors. Most women used simple analgesics for treatment with few using sumatriptan (4) or prophylactic therapy (9). Women were not asked to classify headache but 18 (9%) reported vomiting and are likely to represent the minimum incidence of migraine. Headaches produced considerable morbidity and interference with daily activities social events and work. The effect of menopause and HRT (99 users) on headache was assessed and a group of “hormone sensitive” women identified. Conclusion The problem of menopausal headache is substantial; it is probably under-estimated, under-treated and poorly understood. It certainly deserves further attention.