Frequency Of Headache Among Women In The Outpatient Clinics Of Gynecology And Obstetrics

Abstract

Aim: To evaluate the frequency andtypes of headaches in women presenting to outpatient clinics of Gynecology and Obstetrics with various problems, and to further analyze the possible association between headache types and gynecologic or obstetric diagnosis.Material and Methods: Patients presented to Gynecology and Obstetrics outpatient clinics were enrolled the study. Socio-demographic data, obstetric and/or gynecologic diagnosis, existence of headache were assessed in a face-to-face interview with a structured questionnaire. Among the patients with headache, the characteristics of headache was interviewed with a symptom checklist based on a semi-structured diagnostic headache evaluation, according to criteria of the International Classification of Headache Disorders beta version-3 , and assigned them a clinical diagnosis of migraine, tension-type or other headaches.Results: 205 patients were enrolled the study and 170 patients had headache. Among these, 60.0% had migraine, 31.2% had tension-type headache , 8.8% had other types of headaches. There were no statistically significant association between headache types and gynecological and/or obstetric diseases. However, pregnancy, pelvic pain, and abnormal uterine bleeding were the most frequent obstetric and gynecological diagnosis, respectively, in patients with migraine. Tension-type headache frequency was found to be higher in patients with abnormal uterine bleeding, but this increased frequency showed no statistical significance p>0.05 .Conclusion: Headache is a common comorbid problem accompanying gynecologic and/or obstetric diseases. Since most of the patients with headache complaint had no diagnosis and treatment, it is important to question headache among women, in order to differentiate the possible secondary headaches which can be potential danger particularly in women with pregnancy or postpartum period.

Keywords

• Headache frequency,women,gynecology and obstetrics outpatient clinics

Gebe ve Jinekoloji Polikliniklerine Başvuran Kadınlarda Baş Ağrısı Sıklığı

Abstract

Amaç: Çeşitli nedenlerle jinekoloji ve gebe polikliniklerine başvuran kadınlarda baş ağrısının tipini, sıklığını ve baş ağrısı tipi ile jinekolojik veya obstetric tanı arasındaki muhtemel birlikteliği değerlendirmek.Gereç ve Yöntemler: Bu çalışma jinekoloji ve gebe polikliniklerine başvuran hastalarda yapılmıştır. Sosyodemografik veriler, jinekolojik ve obstetrik tanı, baş ağrısının varlığı yüzyüze görüşme esnasında yapılandırılmış anket formu ile değerlendirilmiştir. Baş ağrısı olan hastalarda, baş ağrısının özellikleri Uluslararası Başağrısı Hastalıkları Sınıflandırması Beta Sürüm-3 kriterlerine gore değerlendirilmiş ve migren, gerilim veya diğer başağrısı tiplerinin klinik tanısı bu kriterlere göre konmuştur.Bulgular: Çalışmaya kayıtlı 205 hastanın 170’inde baş ağrısı vardı. Baş ağrısı olan hastaların %60’ında migren, %31.2’inde gerilim tipi başağrısı, %8.8’inde ise diğer baş ağrısı tipleri vardı. Baş ağrısı tipleri ile jinekolojik ve/veya obstetric hastalıklar arasında istatistiki olarak anlamlı bir birliktelik yoktu. Ancak migrenli hastalarda, gebelik, pelvik ağrı ve anormal uterin kanama en sık rastlanan obstetrik ve jinekolojik tanıydı. Gerilim tipi baş ağrısı en sık anormal uterin kanaması olan hastalarda bulunmuştur fakat istatistiki olarak anlamlı değildir p>0.05 .Sonuç: Baş ağrısı jinekolojik ve/veya obstetrik hastalıklarla birlikte bulunan yaygın bir problemdir. Çünkü baş ağrısı şikayeti olan hastaların çoğu tanı ve tedavi almamıştır. Baş ağrısı olan hastaların sorgulanması, özellikle potansiyel tehlikelere neden olabilecek gebe ve postpartum hastalarda, sekonder baş ağrısı ile ayırım yapılmasında önemlidir.

Keywords

• Baş ağrısı sıklığı,kadın,jinekoloji ve gebe poliklinikleri

References

1. Ravishankar K. The art of history-taking in a headachepatient. Ann Indian Acad Neurol 2012; 15 7–14.
2. Baykan B, Ertas M, Karli N, Akat-Aktas S, Uzunkaya O, Zarifoglu M. et al. The burden of headache in neurology out patient clinics in Turkey. Pain Pract. 2007;7:313-23.
3. Linet MS, Stewart WF, Celentano DD, Ziegler D,Sprecher M.An epidemiologic study of headache among adolescents and young adults. JAMA 1989; 261:2211–16.
4. Smitherman TA, Ward TN. Psychosocial factors of relevance to sex and gender studies in headache. Headache. 2011; 51:923-31.
5. Chai NC1, Peterlin BL, Calhoun AH. Migraine and estrogen Curr Opin Neurol 2014; 27: 315-324.
6. Peterlin BL, Gupta S, Ward TN, Mac Gregor A. Sex matters: evaluating sex and gender in migraine and headache research. Headache 2011; 51: 839–42.
7. Greco R, Tassorelli C, Mangione AS, Smeraldi A, Allena M, Sandrini G, et al. Effect of sex and estrogens on neuronal activation in an animal model of migraine. Headache 2013; 53: 288–96.
8. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33: 629-808.

9. Leonardi M, Steiner TJ, Scher AT, Lipton RB. The global burden of migraine: measuring disability in headache disorders with WHO’s Classification of Functioning, Disability and Health (ICF). J Headache Pain 2005; 6: 429-40.
10. Ertas M, Baykan B, Orhan EK, Zarifoğlu M, Karli N, Saip S, et al.One- year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain 2012; 13:147-57.
11. Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007; 27:192-210.
12. Saper JR; Silberstein SD; Gordon CD; Hamel RL;Swidan S Handbook of Headache Management 2nd edition. Philadelphia, Pa; USA: Lippincott Williams & Wilkins; 1999.
13. Buse DC, Loder EW, Gorman JA, Stewart WF, Reed ML, Fanning KM, et al. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American migraine prevalence and prevention (AMPP) study. Headache 2013; 53:1278–99.
14. Chu MK, Kim DW, Kim BK, Kim JM, Jang TW, Park JW, et al. Gender- specific influence of socioeconomic status onthe prevalence of migraine and tension-type headache: the results from the Korean Headache Survey. J Headache Pain 2013; 4: 14: 82.
15. Chaia NC, Peterlina BL, Calhounb AH. Migraine and estrogen. Curr Opin Neurol. 2014; 27:315–24.
16. Kvisvik EV, Stovner LJ, Helde G, Bovim G, Linde M. Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pain 2011; 12: 443-51.
17. Chancellor AM, Wroe SJ, Cull RE. Migraine occurring for the first time in pregnancy. Headache 1990; 30: 224–27.