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Hormone-withdrawal migraines in the pill-free period could differ from those in the natural cycle. Gynaecologic comorbidities, like dysmenorrhea and endometriosis, but also depression or a family history might modify the course of migraine. A better understanding of migraine features linked to special hormonal situations could improve treatment. For this prospective cohort study, we conducted telephone interviews with women using a CHC and reporting withdrawal migraine to collect information on migraine frequency, intensity, triggers, symptoms, pain medication, gynaecologic history and comorbidities (<jats:italic>n<\/jats:italic>\u2009=\u200948). A subset of women agreed to also document their migraines in prospective diaries. The mean number of migraine days per cycle was 4.2 (\u00b1\u20092.7). Around 50% of these migraines occurred during the hormone-free interval. Migraine frequency was significantly higher in women who suffered from migraine before CHC start (5.0\u2009\u00b1\u20093.1) (<jats:italic>n<\/jats:italic>\u2009=\u200922) in comparison to those with migraine onset after CHC start (3.5\u2009\u00b1\u20092.1) (<jats:italic>n<\/jats:italic>\u2009=\u200926). Menstrually related attacks were described as more painful (57.5%), especially in women with migraine onset before CHC use (72%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02). Comorbidities were rare, except dysmenorrhea. The majority of migraine attacks in CHC users occur during the hormone-free interval. Similar as in the natural cycle<jats:bold>,<\/jats:bold> hormone-withdrawal migraines in CHC users are very intense and the response to acute medication is less good, especially in those women, who developed migraine before CHC use.<\/jats:p>","DOI":"10.1007\/s13760-021-01677-3","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T18:02:51Z","timestamp":1619719371000},"page":"401-409","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical features of migraine with onset prior to or during start of combined hormonal contraception: a prospective cohort study"],"prefix":"10.1007","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8644-773X","authenticated-orcid":false,"given":"Gabriele S.","family":"Merki-Feld","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Sandor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella E.","family":"Nappi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Pohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Schankin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"key":"1677_CR1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1212\/01.wnl.0000196481.57994.09","volume":"66","author":"K Aegidius","year":"2006","unstructured":"Aegidius K, Zwart JA, Hagen K et al (2006) Oral contraceptives and increased headache prevalence: the Head-HUNT study. 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These companies are not involved in the present manuscript. PS Sandor has received honoraria for advisory boards, consulting, and as a speaker, within the past 5\u00a0years, from Novartis, Eli Lilly, TEVA Pharmaceuticals, Allergan, Almirall, Amgen, MindMed, and Gr\u00fcnenthal. These companies are not involved in the present manuscript. RE Nappi had a financial relationship (lecturer, member of advisory boards and\/or consultant) with Bayer HealthCare, Endoceutics, Exceltis, FIDIA, Gedeon Richter, MSD, Novo Nordisk, Palatin, Pfizer, Shionogi, Theramex. These companies are not involved in the present manuscript. H Pohl declares no COI. C Schankin has received honoraria from Novartis, Eli Lilly, TEVA Pharmaceuticals, Allergan, Almirall, Amgen, MindMed, and Gr\u00fcnenthal. These companies are not involved in the present manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval for the course of the study and the applied documents was given by the cantonal ethics committee of Zurich (KEK-stV-Nr 2016-01791). Written consent from the participants was obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}