The role of purity and frequency in the classification of perimenstrual headache.

BMC Neurol

Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.

Published: June 2023

Background: Among all menstruation-associated headaches, only menstrual migraine has classification criteria in the International Classification of Headache Disorders 3rd edition (ICHD-3). Other menstruation-associated headaches are not generally described. The ICHD-3 classifies menstrual migraine according to headache type, timing(on days -2 to +3 of menstruation), frequency (whether headache occurs in at least two out of three menstrual cycles), and purity(whether headache occurs at other times of the menstrual cycle), and provides a reference for research on menstruation-associated headache. However, the role of frequency and purity in the classification of menstruation- associated headache is not clear Moreover, the potential risk factors for high-frequency and pure headaches have not been explored.

Methods: The study was a secondary analysis of an epidemiological survey on menstrual migraine among nurses. Among nurses who had a headache on days -2 to +3 of menstruation, headache frequency, purity, and type were described. High-frequency vs. low-frequency and pure vs. impure headache were compared according to headache features, demographics, occupation-related factors, menstruation-related factors, and lifestyle factors.

Results: Of all respondents, 254(18.3%) nurses who had headaches on days -2 to +3 of menstruation were included in the study. In the 254 nurses with perimenstrual headache, the proportions of migraine, tension type headache (TTH), high-frequency headache, and pure headache were 24.4%, 26.4%, 39.0%, and 42.1%, respectively. High-frequency and impure perimenstrual headache was more severe and similar to migraine. High-frequency headache was associated with more perimenstrual extremity swelling and generalized pain. Other variables were not significantly different between the groups.

Conclusions: Headache except for menstrual migraine accounts for a certain proportion of menstruation-associated headache and should not be ignored in research. Headache frequency and purity are related to headache type and should be equally considered in the classification of menstruation- associated headache. Perimenstrual extremity swelling and generalized pain are potential indicators of high-frequency perimenstrual headache.

Trial Registration: ChiCTR2200056429.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242800PMC
http://dx.doi.org/10.1186/s12883-023-03268-6DOI Listing

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