title: Mid-cycle headaches and their relationship to different patterns of premenstrual stress symptoms.
abstract: 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.
authors.affiliation: Department of Psychology, Università Degli Studi di Padova, Padova, Italy. jeff.kiesner@unipd.it
authors.forename: Jeff
authors.initials: J
authors.lastname: Kiesner
authors.forename: Vincent T
authors.initials: VT
authors.lastname: Martin
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008597:Menstrual Cycle / Q000523:psychology; D011293:Premenstrual Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult