Follow this case of a young woman seen in primary care with a complaint of headache that may sound familiar to you. There are some fine distinctions to be made among headaches that are associated with hormonal changes in women. Find out what you know about diagnosis, acute treatment, and successful management of hormone-related headache.
Haley, a 25-year-old woman, comes to your office for her annual examination. She complains of headaches that occur several days before menses. OTC analgesics like ibuprofen only help somewhat. If untreated, her headaches can last 48-72 hours. There is some relief several days into menses, but then a headache could occur at the end of menses as well. She is frustrated because she does not feel as sharp cognitively in her work as a legal secretary on her headache days.
1. The most likely diagnosis for her headaches is:
A. Premenstrual syndrome (PMS)
B. Tension headache
C. Migraine headache
D. Cluster headache
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