Predictability of exogenous hormone effect on subgroups of migraineurs

Objective.-To evaluate whether self-reported past migraine response to repr oductive life events (menses, pregnancy, menopause) alters the likelihood o f 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 o ral contraceptive use or hormone replacement therapy (67.2% and 77%, respec tively), Worsening of migraines with oral contraceptive use was associated with a menstrual trigger, worsening during pregnancy, and a diagnosis of mi graine without aura. Worsening with hormone replacement therapy was associa ted 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.