Predictability of exogenous hormone effect on subgroups of migraineurs

To evaluate whether self-reported past migraine response to reproductive life events (menses, pregnancy, menopause) alters the likelihood of worsening of migraine with exogenous hormone use.

A retrospective study was conducted on 451 female patients at the University Headache Center who had a diagnosis of migraine with or without aura.

The majority of migraineurs recalled no change in headaches with oral contraceptive use or hormone replacement therapy (67.2% and 77%, respectively). Worsening of migraines with oral contraceptive use was associated with a menstrual trigger, worsening during pregnancy, and a diagnosis of migraine without aura. Worsening with hormone replacement therapy was associated with worsening during prior oral contraceptive use, improvement during pregnancy, worsening during menopause, and a diagnosis of migraine without aura.

Prospective studies are needed to confirm these associations.