Menopausal hormone therapy, migraine history, and headache severity: Results from the Women's Health Initiative Hormone Therapy clinical trials
Abstract
Objective: The aim of this study was to evaluate the association of oral menopausal hormone therapy (estrogen only [E-only] or estrogen and progestin [E+P]), as compared to placebo on postmenopausal headache severity among females with and without a history of migraine in the Women's Health Initiative Hormone Therapy (WHI-HT) trials.
Background: Migraine is three times more common among females than males and is a major source of pain and disability among women throughout the life course. Previous observational research found a positive association between menopausal hormone therapy (MHT) use and migraine prevalence, but the longitudinal association of MHT with postmenopausal migraine severity is unclear.
Methods: We examined changes in self-reported headache severity between baseline and year 1 in 22,876 females (average age 64 years) across the United States enrolled in the WHI-HT trials between 1993 and 1998. We conducted a secondary, stratified analysis of data of two parallel, randomized, placebo-controlled clinical trials to estimate the association of MHT and headache severity overall and stratified by history of migraine at baseline. Additionally, we assessed the association between MHT and headache trajectory, based on whether headaches worsened over the follow-up period.
Results: At baseline, the prevalence of a lifetime migraine diagnosis was 10%. Among participants with a history of migraine, randomization to E-only MHT was not associated with more severe…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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