Migraine prevalence in male to female transsexuals on hormone therapy

Migraine prevalence is three times higher in women than men, suggesting that sex hormones may be involved in migraine generation. To further understand the relationship between migraine and sex hormones, we assessed male to female transsexuals (MFTs) using antiandrogens to suppress male sex characteristics and estrogens to induce female sex characteristics for the presence of headache. The Gender Team Clinic has treated >900 MFTs and provides comprehensive care for 95% of transsexuals in The Netherlands. A questionnaire consisting of eight multiple choice questions on headache frequency, duration, intensity, pain location, associated symptoms, and visual phenomena was distributed during a 4-month period to MFTs who had recently completed sex reassignment surgery. Headaches before taking hormone therapy were not assessed because of the long period (years) many patients had taken treatment. Migraine diagnosis was based on satisfaction of International Headache Society (IHS) criteria. We calculated the expected number of persons with migraine based on …