Menstrual tension-type headache: evidence for its existence

OBJECTIVE: To determine whether menstrual tension-type headache is a real disorder. BACKGROUND: An appendix was included in the second edition of the International Classification of Headache Disorders by the International Headache Society. Diagnostic criteria are proposed in this appendix for 2 types of menstrual migraine: pure menstrual migraine without aura and menstrually related migraine without aura. References to menstrual tension-type headache do not appear in this classification. METHODS: In a neurological outpatient clinic 165 patients were identified in whom headache was related to menstruation and the criteria of the International Classification of Headache Disorders for menstrual migraine adapted to menstrual tension-type headache were applied. RESULTS: Twenty-one patients met the criteria of menstrual tension-type headache, 6 for pure menstrual tension-type headache, and 15 for menstrually related tension-type headache. CONCLUSION: Menstrual tension-type headache is a real condition that should be recognized in the International Classification of Headache Disorders.