{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T08:04:40Z","timestamp":1789286680001,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N92021D00001"],"award-info":[{"award-number":["75N92021D00001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N92021D00002"],"award-info":[{"award-number":["75N92021D00002"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N92021D00003"],"award-info":[{"award-number":["75N92021D00003"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N92021D00004"],"award-info":[{"award-number":["75N92021D00004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N92021D00005"],"award-info":[{"award-number":["75N92021D00005"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U54AG062322"],"award-info":[{"award-number":["U54AG062322"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the association of oral menopausal hormone therapy (estrogen only [E\u2010only] or estrogen and progestin [E+P]), as compared to placebo on postmenopausal headache severity among females with and without a history of migraine in the Women's Health Initiative Hormone Therapy (WHI\u2010HT) trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine is three times more common among females than males and is a major source of pain and disability among women throughout the life course. Previous observational research found a positive association between menopausal hormone therapy (MHT) use and migraine prevalence, but the longitudinal association of MHT with postmenopausal migraine severity is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined changes in self\u2010reported headache severity between baseline and year 1 in 22,876 females (average age 64\u2009years) across the United States enrolled in the WHI\u2010HT trials between 1993 and 1998. We conducted a secondary, stratified analysis of data of two parallel, randomized, placebo\u2010controlled clinical trials to estimate the association of MHT and headache severity overall and stratified by history of migraine at baseline. Additionally, we assessed the association between MHT and headache trajectory, based on whether headaches worsened over the follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, the prevalence of a lifetime migraine diagnosis was 10%. Among participants with a history of migraine, randomization to E\u2010only MHT was not associated with more severe headache at 1 year (adjusted odds ratio [aOR]\u2009=\u20091.14, 95% confidence interval [CI]: 0.90\u20131.44), or worsening headache trajectory (adjusted risk ratio [aRR]\u2009=\u20090.98, 95% CI: 0.71\u20131.34) after 1 year. Randomization to E+P MHT was modestly associated with more severe headache, although estimates did not reach statistical significance (aOR\u2009=\u20091.21, 95% CI: 0.98\u20131.50). E+P MHT was significantly associated with worsening headache trajectory (aRR=\u20091.53, 95% CI: 1.14\u20132.03). Among those without a migraine history, E\u2010only MHT was not strongly associated with moderate\u2010to\u2010severe headache severity (aOR: 1.11, 95% CI: 1.01\u20131.21) or worsening headache trajectory (aRR\u2009=\u20091.08 95% CI: 0.96\u20131.22) after 1 year. However, E+P MHT was associated with modestly increased odds of moderate\u2010to\u2010severe headache severity (aOR\u2009=\u20091.14, 95% CI: 1.06\u20131.23) and a higher likelihood of worsening headache trajectory (aRR\u2009=\u20091.18, 95% CI: 1.07\u20131.30) after 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study of MHT in the WHI hormone therapy trial participants, E\u2010only MHT was not associated with increased odds of more severe postmenopausal headache severity. Among those with a history of migraine, E+P MHT was associated with more severe and worsening postmenopausal headache. Further research on the effect of newer MHT formulations on postmenopausal headache is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.70168","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T22:52:21Z","timestamp":1783551141000},"page":"1741-1752","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Menopausal hormone therapy, migraine history, and headache severity: Results from the Women's Health Initiative Hormone Therapy clinical trials"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9164-532X","authenticated-orcid":false,"given":"Holly M.","family":"Crowe","sequence":"first","affiliation":[{"name":"Division of Women's Health, Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy E.","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Robert Larner, MD College of Medicine, University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet W.","family":"Rich\u2010Edwards","sequence":"additional","affiliation":[{"name":"Division of Women's Health, Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aladdin H.","family":"Shadyab","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health and Human Longevity Science and Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longjian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie V.","family":"Farland","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Mel and Enid Zuckerman School of Public Health, University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.","family":"Schnatz","sequence":"additional","affiliation":[{"name":"Departments of ObGyn &amp; Internal Medicine Rowan\u2010Virtua School of Osteopathic Medicine  Stratford New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnn E.","family":"Manson","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Epidemiology Harvard T.H. 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