Mid‐Cycle Headaches and Their Relationship to Different Patterns of Premenstrual Stress Symptoms

Background Recent research has shown that affective changes associated with the menstrual cycle may follow diverse patterns, including a classic premenstrual syndrome pattern, as well as the mirror opposite pattern, referred to as a mid‐cycle pattern . Objective Test for the presence of a mid‐cycle pattern of headaches, in addition to a menstrual pattern and a noncyclic pattern; test for an association between experiencing a specific pattern of headaches and a specific (previously identified) pattern of depression/anxiety; and test for mean‐level differences, across headache pattern groups, in average headache index and depression/anxiety scores (averaged across 2 menstrual cycles for each participant). Methods A sample of 213 female university students completed daily questionnaires regarding symptoms of headaches and depression/anxiety for 2 menstrual cycles. Hierarchical linear modeling, polynomial multiple regression, analyses of variance, and chi‐square analyses were used to test the hypotheses. Results Confirmed the existence of a mid‐cycle pattern of headaches (16%), in addition to a menstrual pattern (51%), and a noncyclic pattern of headaches (33%). Patterns of headaches and affective change were significantly associated (χ 2  = 21.33, P  = .0003; 54% correspondence), as were the average headache index and depression/anxiety scores ( r  = .49; P  < .0001). No significant mean‐level differences were found between the headache pattern groups on the average headache index scores or depression/anxiety scores. Conclusions A significant number of women experience a mid‐cycle pattern of headaches during the menstrual cycle. Moreover, women often, but not always, demonstrate the same pattern of headaches and depression/anxiety symptoms.