Increased headache prevalence in female adolescents and adult women with early menarche. The Head-HUNT Studies

BACKGROUND: Age at menarche is associated with cardiovascular events and lifestyle factors such as body mass index (BMI), certain women's diseases like breast cancer and endometriosis and with occurrence of certain physical symptoms during puberty. It is unclear whether age at menarche is an independent determinant of headache. OBJECTIVES: The aim of the study was to explore age of menarche in relation to headache prevalence in a large population-based study of both adolescents and adult women (HUNT). METHODS: In the Nord-Trøndelag Health Study in Norway 1995-97 (HUNT 2), a total of 26,636 (57%) of 46,506 invited women responded to questions regarding menarche and headache (Head-HUNT). In the youth part of HUNT 2, 3196 female students were interviewed about their headache complaints and 2766 (87%) responded to questions regarding menarche. All the final analyses were adjusted for age, use of oral contraceptives and BMI, and for adults also for educational level. RESULTS: Headache was more prevalent amongst females with menarche ≤ 12 years, both amongst adolescents (OR=1.3, 95% CI=1.1-1.5) and adults (OR=1.1, 95% CI=1.1-1.2), evident for migraine and non-migrainous headache. CONCLUSION: Headache, both migraine and non-migrainous headache, was more prevalent amongst both adolescents and adult females with early menarche. Early menarche may increase headache susceptibility, or be a consequence of a common pathogenetic factor, e.g., sensitivity to estrogens.