Clinical aspects of migraine in relation to the menstrual cycle: increasing accuracy using an electronic headache diary

Abstract

In this thesis sex differences in migraine symptomatology and sex-specific aspects of migraine are assessed with a focus on differences between perimenstrual and non-perimenstrual migraine attacks. Remarkably little is known about sex differences in the clinical presentation of migraine and female-specific aspects of migraine, despite obvious sex differences in prevalence. There is currently no female-specific approach or treatment that acts on sex hormones, although the relation to the menstrual cycle is indisputable. The first part of this thesis seeks to increase our understanding of menstrual migraine and includes recommendations to improve diagnostic criteria. The second part examines sex differences in the clinical presentation of a migraine attack, addresses possible clinical manifestations of sex hormones in men with migraine and offers practical guidelines for sex-specific treatment.