Predictability of Exogenous Hormone Effect on Subgroups of Migraineurs


Address all correspondence to Dr. Loretta Mueller, University Headache Center, 513 South Lenola Road, Moorestown, NJ 08057.


Objective.–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.

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

Results.–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.

Conclusions.–Prospective studies are needed to confirm these associations.