Abstract
The effect of menopausal hormone therapy on headache and migraine severity: results from the Women's Health Initiative Hormone Therapy Clinical Trials
Headache, v 65(S1), pp 100-100
01 Jun 2025
PMID: 40536326
Abstract
Background: Migraine is three times more common among women than men and is a major source of pain and disability among women throughout the life course. Previous cross-sectional research found a positive association between using menopausal hormone therapy (MHT) use and migraine prevalence, but the longitudinal impact of MHT on postmenopausal migraine severity is unknown.
Methods: We examined changes in self-reported headache severity between baseline and year 1 of the WHI MHT trial using logbinomial regression to estimate the effect of MHT on headache severity, stratifying by history of migraine at baseline.
Results: The prevalence of a baseline lifetime history of migraine in the population was 10%. Thirty-five percent of individuals with a history of migraine and 8% of individuals without a history of migraine reported moderate to severe headaches at year 1. Migraine history was a significant predictor of worsening headache after controlling for MHT use (RR = 1.45, 95%CI 1.34–1.56). Randomized MHT was associated with a small increase in risk of moderate to severe (vs. none or mild) headache at year 1, regardless of migraine history (Eonly RR = 1.11, 95% CI: 0.94–1.30, E+P RR = 1.20 95% CI: 1.01–1.42). Randomization to E+P was associated with a slight increase in risk of worsening headache (RR = 1.15, 95% CI: 1.06–1.24), while randomization to E-only did not increase headache severity (RR = 1.04, 95% CI: 0.95–1.14). Estimates were similar among those with and without a history of migraine (pinteraction >05.)
Conclusion: Allocation to randomized MHT conferred a slightly higher risk of more severe headache after 1 year. While randomization to E+P was associated with a small risk of worsening headache, this increase in risk was not present among those randomized to Eonly. Risk of worsening headache did not differ among subgroups with or without a history of migraine.
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Details
- Title
- The effect of menopausal hormone therapy on headache and migraine severity: results from the Women's Health Initiative Hormone Therapy Clinical Trials
- Creators
- H M Crowe - Brigham and Women's HospitalKathryn Rexrode - Brigham and Women's HospitalJanet W. Rich-Edwards - Brigham and Women's HospitalT Madsen - University of VermontAladdin H. Shadyab - University of California San DiegoLongjian Liu - Drexel University, Epidemiology and BiostatisticsLeslie V. Farland - University of ArizonaPeter F Schnatz - Drexel UniversityMarcia Stefanick - Stanford University School of Medicine
- Publication Details
- Headache, v 65(S1), pp 100-100
- Conference
- American Headache Society 67th Annual Scientific Meeting, 67th (Minneapolis, Minnesota, United States, 19 Jun 2025–22 Jun 2025)
- Publisher
- Wiley
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001716976300115
- Scopus ID
- 2-s2.0-105009390780
- Other Identifier
- 991022173070304721
InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology