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

• Published in: Journal of headache and pain Vol. 22; no. 1; p. 125
• Main Authors: Verhagen, Iris E., Brandt, Roemer B., Kruitbosch, Carlijn M. A., MaassenVanDenBrink, Antoinette, Fronczek, Rolf, Terwindt, Gisela M.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-12-2021; Springer Nature B.V; BMC
• Subjects: Aging; Androgens; Cohort analysis; Generalized linear models; Headache; Headaches; Internal Medicine; Libido; Males; Medicine; Medicine & Public Health; Mens health; Mental depression; Migraine; Morning erections; Neurology; Pain Medicine; Patients; Questionnaires; Research Article; Sex hormones; Sexual potency; Headache; Sex hormones; Libido; Morning erections; Sexual potency
• ISSN: 1129-2369; 1129-2377
• DOI: 10.1186/s10194-021-01334-3

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 less 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.