Clinical symptoms of androgen deficiency in men with migraine or cluster headache: a cross-sectional cohort study

Iris E. Verhagen*, Roemer B. Brandt, Carlijn M.A. Kruitbosch, Antoinette MaassenVanDenBrink, Rolf Fronczek, Gisela M. Terwindt

*Corresponding author for this work

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Background: To compare symptoms of clinical androgen deficiency between men with migraine, men with cluster headache and non-headache male controls. Methods: We performed a cross-sectional study using two validated questionnaires to assess symptoms of androgen deficiency in males with migraine, cluster headache, and non-headache controls. Primary outcome was the mean difference in androgen deficiency scores. Generalized linear models were used adjusting for age, BMI, smoking and lifetime depression. As secondary outcome we assessed the percentage of patients reporting to score below average on four sexual symptoms (beard growth, morning erections, libido and sexual potency) as these items were previously shown to more specifically differentiate androgen deficiency symptoms from (comorbid) anxiety and depression. Results: The questionnaires were completed by n = 534/853 (63%) men with migraine, n = 437/694 (63%) men with cluster headache and n = 152/209 (73%) controls. Responders were older compared to non-responders and more likely to suffer from lifetime depression. Patients reported more severe symptoms of clinical androgen deficiency compared with controls, with higher AMS scores (Aging Males Symptoms; mean difference ± SE: migraine 5.44 ± 0.90, p < 0.001; cluster headache 5.62 ± 0.99, p < 0.001) and lower qADAM scores (quantitative Androgen Deficiency in the Aging Male; migraine: − 3.16 ± 0.50, p < 0.001; cluster headache: − 5.25 ± 0.56, p < 0.001). Additionally, both patient groups more often reported to suffer from any of the specific sexual symptoms compared to controls (18.4% migraine, 20.6% cluster headache, 7.2% controls, p = 0.001). Conclusion: Men with migraine and cluster headache more often suffer from symptoms consistent with clinical androgen deficiency than males without a primary headache disorder.

Original languageEnglish
Article number125
JournalJournal of Headache and Pain
Issue number1
Early online date19 Oct 2021
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information:
I.E. Verhagen has received research grants from ZonMw and the Dutch Brain Foundation. R.B. Brandt has received support for conference visits from Allergan. C.M.A. Kruitbosch reports no disclosures. A. MaassenVanDenBrink reports consultancy or industry support from Novartis, Lilly and Teva, and independent support from the Dutch Research Council (VICI grant 09150181910040), The Netherlands Organisation for Health Research and Development (ZonMw) and the Dutch Heart & Brain Foundations. R. Fronczek has received consultancy support from Novartis, Lilly, Teva, Allergan, and independent support from the Dutch Brain Foundation and Innovation Fund Dutch Healthcare Providers. G.M. Terwindt reports consultancy support from Novartis, Allergan, Lilly, and Teva, and independent support from Dutch Organization for Scientific Research, the Dutch Heart & Brain Foundations, IRRF and Dioraphte.

Publisher Copyright:
© 2021, The Author(s).


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