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Pure menstrual tension-type headache: demonstration of its existence

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Abstract

Introduction and objective

Menstrual migraine (MM) is widely recognized among the scientific community, with diagnostic criteria included in the appendix of the third edition of the International Headache Classification. However, this classification does not include other primary headaches that may occur during menstruation. Previous retrospective studies suggest the existence of menstrual tension-type headache. Our objective is to prospectively determine the existence of this type of headache and to determine its frequency relative to that of MM.

Methods

This is a descriptive, cross-sectional (case series), prospective, observational study, conducted in a hospital neurology department, using a previously validated ad hoc questionnaire. Participants were recruited by consecutive sampling, applying inclusion and exclusion criteria among women accompanying neurology outpatients, and classified into five groups: pure menstrual tension-type headache, menstrual-related tension-type headache, pure menstrual migraine, menstrual-related migraine and unclassifiable.

Results

Ninety-five women (median age of 38.50 years, IQR: 13) were included, with the following group distribution: 13 (13.6%) pure menstrual tension-type headache, 14 (14.7%) menstruation-related tension-type headache, 23 (24.2%) pure menstrual migraine, 44 (46.3%) menstrual-related migraine and 1 unclassifiable. Of these patients, 23% did not treat menstrual headache, but this figure rose to 30.8% in the case of pure menstrual tension-type headache.

Conclusion

The results confirm the existence of pure menstrual tension-type headache among women who do not seek medical care for this condition. The frequency of this headache is lower than that of MM. This reduced incidence, together with its generally mild nature, may explain the lack of prior recognition.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Correspondence to Antonio Arjona-Padillo.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and national researcher committee (Law 14/2007 of July 3, 2007 on Biomedical Research, Spain) and with the 1964 Helsinki declaration in its later amendments.

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Informed consent was obtained from the patients included in the study.

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Ruiz-Franco, M.L., Arjona-Padillo, A., Martínez-Simón, J. et al. Pure menstrual tension-type headache: demonstration of its existence. Acta Neurol Belg 124, 257–262 (2024). https://doi.org/10.1007/s13760-023-02389-6

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