title: An online survey of exercise-related headaches among cyclists.
abstract: BACKGROUND
  Primary exertional headache (PEH) is a long-known phenomenon. Divergent prevalences of between 0.2 and 12.3% are reported among the general population. The aim of this study was to establish the prevalence among an athletic population.
  
  
  METHODS
  A link to an online questionnaire was sent to all participants of a tough cycling event held in The Netherlands.
  
  
  RESULTS
  Four thousand participants filled out the questionnaire. One thousand eight hundred and ten (45%) stated that they had suffered, at least once in their lives, from exercise-related headaches (EHs). Thirty-seven percent (668) of them had those headaches at least once a month and 10% (174) experienced a weekly occurrence. The rate of female cyclists with a history of EHs was 54%. With an increasing age, a decline of EHs was found. Five hundred eighty-one (37%) of the participants used medication for EHs.
  
  
  CONCLUSIONS
  An estimation of the prevalence of PEHs among the studied population by comparison to the International Headache Society criteria resulted in a rate of 26%. The lower prevalence among older cyclists could be caused by avoidance of (high-intensity) exercise due to the burden that EH brings along. PEH appears to be quite common among an athletic population and merits further investigation.
authors.affiliation: Department of Sports Medicine, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: van der Ende-Kastelijn
authors.forename: Willem
authors.initials: W
authors.lastname: Oerlemans
authors.forename: Simon
authors.initials: S
authors.lastname: Goedegebuure
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001642:Bicycling / Q000502:physiology*; D003625:Data Collection / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005260:Female; D051270:Headache Disorders, Primary / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009862:Online Systems; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: cycling; exertional headache; headache; physical exertion; prevalence