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Association of menopausal type and hormone therapy with headache in a large Taiwanese cohort
Sheng-Hao Chang1, Yi-Chun Yeh2, Liang-Chi Huang3
1Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Objectives:
To examine associations of menopausal status, menopause type, and use of hormone replacement therapy with the prevalence of headache.
Study Design:
Cross-sectional, population-based analysis of 14,625 women from the Taiwan Biobank (2012-2018). Menopausal status, menopause type (natural versus surgical), use of hormone replacement therapy, and headache were self-reported. Multivariable logistic regression models were constructed to estimate associations, adjusting for demographic characteristics, reproductive history, lifestyle factors, comorbidities, and relevant clinical variables.
Main Outcome Measures:
Self-reported physician-diagnosed headache, overall and stratified by menopausal status (premenopausal versus postmenopausal), menopause type (natural versus surgical), and use of hormone replacement therapy. Associations were quantified using adjusted odds ratios with 95% confidence intervals derived from multivariable logistic regression models.
Results:
The prevalence of headache was lower among postmenopausal than premenopausal women (22% versus 38%; adjusted odds ratio [OR] 0.82; 95% confidence interval [CI] 0.69-0.96). Natural menopause was independently associated with a significantly lower prevalence of headache (adjusted OR 0.83; 95% CI 0.67-0.98). Surgical menopause demonstrated a similarly significant inverse association (adjusted OR 0.79; 95% CI 0.63-0.98), with a point estimate numerically lower than that of natural menopause. Among postmenopausal women, use of hormone replacement therapy was consistently linked to increased headache: adjusted OR 1.40 (95% CI 1.15-1.71) for natural menopause and adjusted OR 1.95 (95% CI 1.33-2.88) for surgical menopause.
Conclusions:
Both natural menopause and surgical menopause were associated with a lower prevalence of headache, whereas use of hormone replacement therapy was associated with a higher prevalence among postmenopausal women. However, the cross-sectional design precludes strong conclusions regarding causal relationships, and these findings should be interpreted with caution.
