Elisa T Bushman1, Michael W Varner2, Kathleen B Digre3. 1. Resident Physician. 2. Professor, Department of Obstetrics and Gynecology. 3. Professor, Departments of Neurology and Ophthalmology, University of Utah Health Sciences Center, Salt Lake City, UT.
Abstract
IMPORTANCE: Headaches affect women across their life span, with menses, pregnancy, and menopause being times that pose unique challenges in diagnosis and treatment. The correct diagnosis and treatment of headache can prevent unnecessary interventions, the worsening of chronic headache disorders, and complications of secondary headaches. OBJECTIVE: The objective of this article is to educate women's health care providers about the diagnosis, differential diagnosis, and treatment of headache during menses, pregnancy, the puerperium, and menopause to improve the quality of care for women with chronic and acute headache. EVIDENCE ACQUISITION: Current articles were reviewed addressing headache during menses, pregnancy, the postpartum period, and menopause. Articles with the highest level of evidence were compiled in this article to provide a summary of recommendations. RESULTS: Multiple diagnostic and therapeutic options for chronic and acute headache are available for women regardless of their stage in life or comorbidities. CONCLUSIONS AND RELEVANCE: The effects of headaches span a woman's life span, with puberty and menopause being times of increased frequency. Pregnancy is an at-risk time for women to develop secondary headache disorders. All women's health care providers should know how to screen for, diagnose, and treat headache at all stages of a woman's life. Effective treatment options are available for acute and chronic headache both during and outside pregnancy.
IMPORTANCE: Headaches affect women across their life span, with menses, pregnancy, and menopause being times that pose unique challenges in diagnosis and treatment. The correct diagnosis and treatment of headache can prevent unnecessary interventions, the worsening of chronic headache disorders, and complications of secondary headaches. OBJECTIVE: The objective of this article is to educate women's health care providers about the diagnosis, differential diagnosis, and treatment of headache during menses, pregnancy, the puerperium, and menopause to improve the quality of care for women with chronic and acute headache. EVIDENCE ACQUISITION: Current articles were reviewed addressing headache during menses, pregnancy, the postpartum period, and menopause. Articles with the highest level of evidence were compiled in this article to provide a summary of recommendations. RESULTS: Multiple diagnostic and therapeutic options for chronic and acute headache are available for women regardless of their stage in life or comorbidities. CONCLUSIONS AND RELEVANCE: The effects of headaches span a woman's life span, with puberty and menopause being times of increased frequency. Pregnancy is an at-risk time for women to develop secondary headache disorders. All women's health care providers should know how to screen for, diagnose, and treat headache at all stages of a woman's life. Effective treatment options are available for acute and chronic headache both during and outside pregnancy.