Impact of Puberty in Girls on Prevalence of Primary Headache Disorder Among Female Schoolchildren in Kuwait

Abdelrahman Alashqar 1, Sameera Shuaibi 2, Samar Farouk Ahmed 3 4, Hawraa AlThufairi 1, Shaikhah Owayed 1, Fajer AlHamdan 5, Raed Alroughani 6, Jasem Yousef Al-Hashel 3 5

Affiliations

17 July 2020

-

doi: 10.3389/fneur.2020.00594

Abstract

Background: The prevalence of primary headaches in the pediatric population is shaped by many factors, of which pubertal status may possibly play a substantial role. Epidemiological studies in the pediatric population in the gulf region remain scarce. 

Aims and objectives: To examine the impact of puberty on the prevalence of primary headache disorders among female schoolchildren in Kuwait. 

Methods: We conducted a cross-sectional study that included Kuwaiti primary and middle schoolgirls in randomly selected schools located in two governorates in Kuwait during the academic year 2018/2019. Prevalence of headache was assessed using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents. Female students were asked about their menarchal status and whether they attained menarche before or after experiencing headaches. 

Results: The questionnaire was completed by 669 girls with a mean age of 11.44 ± 2.14 years. The 1-year prevalence of migraine headache disorder among girls was 23.62%, and the lifetime prevalence of any headache was 84.9%, whereas the 1-year prevalence of primary headache disorders was 47.98%. The mean age of girls with headaches was 11.44 ± 2.14 years. With respect to diagnostic criteria, migraine headache was the most frequently reported (23.62%), followed by tension-type headaches (20.93%), chronic headaches (2.99%), and probable medication-overuse headaches (0.45%). Postpubertal females were at significantly higher risk of having primary headaches compared to their prepubertal counterparts (64.26 vs. 34%; p < 0.0001). All types of primary headaches were more significantly prevalent among postpubertal girls compared to those who are prepubertal. Conclusion: Migraine headache is commonly reported among Kuwaiti schoolgirls. Postpubertal females are at higher risk of developing primary headaches compared to prepubertal females. Pubertal transition and female sex hormones may play a significant role in the pathophysiology of headaches, migraines in particular, and further research is therefore needed to investigate the underlying mechanisms.

Keywords: migraine; primary headache; puberty; school students; sex hormones; tension type headache.

Similar articles

Primary Headache Disorder Among School Students in Kuwait.

Shuaibi S, AlAshqar A, Ahmed SF, Alroughani R, AlThufairi H, Owayed S, AlHamdan F, Al-Hashel J.Front Neurol. 2021 Feb 2;12:621017. doi: 10.3389/fneur.2021.621017. eCollection 2021.PMID: 33603711 Free PMC article.

Impact of primary headache disorder on quality of life among school students in Kuwait.

Al-Hashel JY, Alroughani R, Shuaibi S, AlAshqar A, AlHamdan F, AlThufairi H, Owayed S, Ahmed SF.J Headache Pain. 2020 Jun 24;21(1):80. doi: 10.1186/s10194-020-01124-3.PMID: 32580704 Free PMC article.

Prevalence and Burden of Primary Headache Disorders in Kuwaiti Children and Adolescents: A Community Based Study.

Al-Hashel JY, Ahmed SF, Alroughani R.Front Neurol. 2019 Jul 30;10:793. doi: 10.3389/fneur.2019.00793. eCollection 2019.PMID: 31417482 Free PMC article.

The prevalence and impact of headache in Brazil.

Queiroz LP, Silva Junior AA.Headache. 2015 Feb;55 Suppl 1:32-8. doi: 10.1111/head.12511. Epub 2015 Feb 6.PMID: 25659407 Review.

Cited by

Primary headache epidemiology in children and adolescents: a systematic review and meta-analysis.

Onofri A, Pensato U, Rosignoli C, Wells-Gatnik W, Stanyer E, Ornello R, Chen HZ, De Santis F, Torrente A, Mikulenka P, Monte G, Marschollek K, Waliszewska-Prosół M, Wiels W, Boucherie DM, Onan D, Farham F, Al-Hassany L, Sacco S; European Headache Federation School of Advanced Studies (EHF-SAS).J Headache Pain. 2023 Feb 14;24(1):8. doi: 10.1186/s10194-023-01541-0.PMID: 36782182 Free PMC article. Review.

Migraine and its association with pubertal maturation and behavioral traits among adolescent girls.

Martin VT, Fassler CS, Brunst KJ, Ying J, Teitelbaum S, Windham GC, Deardorff J, Wolff MS, Kushi LH, Biro FM, Pinney SM.Acta Neurol Belg. 2023 Aug;123(4):1279-1289. doi: 10.1007/s13760-022-02161-2. Epub 2023 Jan 11.PMID: 36631631

Laboured reading and musculoskeletal pain in school children - the role of lifestyle behaviour and eye wear: a cross-sectional study.

Thorud HS, Mork R, Bjørset CO, Gilson SJ, Hagen LA, Langaas T, Pedersen HR, Svarverud E, Vikesdal GH, Baraas RC.BMC Pediatr. 2022 Jul 13;22(1):416. doi: 10.1186/s12887-022-03465-1.PMID: 35831809 Free PMC article.

Primary Headache Disorder Among School Students in Kuwait.

Shuaibi S, AlAshqar A, Ahmed SF, Alroughani R, AlThufairi H, Owayed S, AlHamdan F, Al-Hashel J.Front Neurol. 2021 Feb 2;12:621017. doi: 10.3389/fneur.2021.621017. eCollection 2021.PMID: 33603711 Free PMC article.

KMEL References

https://pubmed.ncbi.nlm.nih.gov/

References

  1.  
    1. Bille B. Migraine and tension-type headache in children and adolescents. Cephalalgia. (1996) 16, 78. - PubMed
  2.  
    1. Keight R, Al-Jumeily D, Hussain AJ, Al-Jumeily M, Mallucci C. Towards the discrimination of primary and secondary headache: An intelligent systems approach. In: 2017 International Joint Conference on Neural Networks (IJCNN). IEEE; (2017). p. 2768–75. 10.1109/IJCNN.2017.7966197 - DOI
  3.  
    1. Fearon P, Hotopf M. Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. BMJ. (2001) 322:1145. 10.1136/bmj.322.7295.1145 - DOI - PMC - PubMed
  4.  
    1. Passchier J, Orlebeke JF. Headaches and stress in schoolchildren: an epidemiological study. Cephalalgia. (1985) 5:167–76. 10.1046/j.1468-2982.1985.0503167.x - DOI - PubMed
  5.  
    1. Stovner LJ, Hagen K, Jensen Rf, Katsarava Z, Richard Lipton B, Scher AI, et al. . The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. (2007) 27:193–210. 10.1111/j.1468-2982.2007.01288.x - DOI - PubMed
  6.  
    1. Mortimer MJ, Kay J, Jaron A. Epidemiology of headache and childhood migraine in an urban general practice using ad hoc, vahlquist and ihs criteria. Dev Med Child Neurol. (2008) 34:1095–101. 10.1111/j.1469-8749.1992.tb11423.x - DOI - PubMed
  7.  
    1. Delaruelle Z, Ivanova TA, Khan S, Negro A, Ornello R, Raffaelli B, et al. . Male and female sex hormones in primary headaches. J Headache Pain. (2018) 19:117. 10.1186/s10194-018-0922-7 - DOI - PMC - PubMed
  8.  
    1. Borsook D, Erpelding N, Lebel A, Linnman C, Veggeberg R, Grant PE, et al. . Sex and the migraine brain. Neurobiol Dis. (2014) 68:200–14. 10.1016/j.nbd.2014.03.008 - DOI - PMC - PubMed
  9.  
    1. Wöber-Bingöl Ç, Wöber C, Uluduz D, Uygunoglu U, Aslan TS, Kernmayer M, et al. . The global burden of headache in children and adolescents–developing a questionnaire and methodology for a global study. J Headache Pain. (2014) 15:86. 10.1186/1129-2377-15-86 - DOI - PMC - PubMed
  10.  
    1. Steiner TJ, Gururaj G, Andrée C, Katsarava Z, Ayzenberg I, Yu SY, et al. . Diagnosis, prevalence estimation and burden measurement in population surveys of headache: presenting the HARDSHIP questionnaire. J Headache Pain. (2014) 15:3. 10.1186/1129-2377-15-3 - DOI - PMC - PubMed
  11.  
    1. Headache Classification Committee of the International Headache Society (IHS) The international classification of headache disorders. Cephalalgia. (2018) 38:1–211. 10.1177/0333102417738202 - DOI - PubMed
  12.  
    1. Foster CG. International ethical guide- lines for biomedical research involving human subjects. J Med Ethics. (1994) 20:123–4. 10.1136/jme.20.2.123 - DOI
  13.  
    1. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects (2008). Available online at: http://www.wma.net/e/policy/b3.htm - PubMed
  14.  
    1. Philipp Julia, Michael Zeiler, Christian Wöber, Gudrun Wagner, Andreas FK, Karwautz, et al. . Prevalence and burden of headache in children and adolescents in Austria–a nationwide study in a representative sample of pupils aged 10–18 years. J Headache Pain. (2019) 20:101. 10.1186/s10194-019-1050-8 - DOI - PMC - PubMed
  15.  
    1. Genizi J, Srugo I, Kerem NC. The cross-ethnic variations in the prevalence of headache and other somatic complaints among adolescents in Northern Israel. J Headache Pain. (2013) 14:21. 10.1186/1129-2377-14-21 - DOI - PMC - PubMed
  16.  
    1. Wöber-Bingöl Ç . Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep. (2013) 17:341. 10.1007/s11916-013-0341-z - DOI - PubMed
  17.  
    1. Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol. (2010) 52:1088–97. 10.1111/j.1469-8749.2010.03793.x - DOI - PubMed
  18.  
    1. Kröner-Herwig B, Vath N. Menarche in girls and headache–a longitudinal analysis. Headache. (2009) 49:860–7. 10.1111/j.1526-4610.2009.01397.x - DOI - PubMed
  19.  
    1. Martin VT, Lipton RB. Epidemiology and biology of menstrual migraine. Headache. (2008) 48:S124–30. 10.1111/j.1526-4610.2008.01310.x - DOI - PubMed
  20.  
    1. Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis—part I. Headache. (2006) 46:3–23. 10.1111/j.1526-4610.2006.00309.x - DOI - PubMed
  21.  
    1. Al-Hashel JY, Ahmed SF, Alroughani R. Prevalence and burden of primary headache disorders in kuwaiti children and adolescents: a community based study. Front Neurol. (2019) 10:793. 10.3389/fneur.2019.00793 - DOI - PMC - PubMed
  22.  
    1. Laurell K, Larsson B, Eeg-Olofsson O. Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia. (2004) 24:380–8. 10.1111/j.1468-2982.2004.00681.x - DOI - PubMed
  23.  
    1. Bianchin L, Bozzola M, Battistella Pier A, Bernasconi S, Bona G, Buzi F, et al. . Menstrual cycle and headache in teenagers. Indian J Pediatr. (2019) 86:25–33. 10.1007/s12098-018-2829-3 - DOI - PubMed
  24.  
    1. Aegidius KL, Zwart JA, Hagen K, Dyb G, Holmen TL, Stovner LJ. Increased headache prevalence in female adolescents and adult women with early menarche. The head-hunt studies. Eur J Neurol. (2011) 18:321–8. 10.1111/j.1468-1331.2010.03143.x - DOI - PubMed
  25.  
    1. Fenzi F, Rizzzuto N. Estrogen receptors localization in the spinal trigeminal nucleus: an immunohistochemical study in humans. Eur J Pain. (2011) 15:1002–7. 10.1016/j.ejpain.2011.05.003 - DOI - PubMed
  26.  
    1. Gupta S, McCarson KE, Welch KM, Berman NE. Mechanisms of pain modulation by sex hormones in migraine. Headache. (2011) 51:905–22. 10.1111/j.1526-4610.2011.01908.x - DOI - PubMed
  27.  
    1. Burstein R, Jakubowski M, Garcia-Nicas E, Kainz V, Bajwa Z, Hargreaves R, et al. . Thalamic sensitization transforms localized pain into widespread allodynia. Ann Neurol. (2010) 68:81–91. 10.1002/ana.21994 - DOI - PMC - PubMed
  28.  
    1. Epstein MT, Hockaday JM, Hockaday TD. Migraine and reproductive hormones throughout the menstrual cycle. Lancet. (1975) 305:543–8. 10.1016/S0140-6736(75)91558-5 - DOI - PubMed
  29.  
    1. Farello G, Ferrara P, Antenucci A, Basti C, Verrotti A. The link between obesity and migraine in childhood: a systematic review. Ital J Pediatr. (2017) 43:27. 10.1186/s13052-017-0344-1 - DOI - PMC - PubMed
  30.  
    1. Marcus DA. Sex hormones and chronic headache in women. Expert Opin Pharmacother. (2001) 2:1839–48. 10.1517/14656566.2.11.1839 - DOI - PubMed

Page Navigation