Differences of Cluster Headache on the Basis of Sex in the Korean Cluster Headache Registry

Background Most of the clinical characteristics of cluster headache (CH) have been established through the observation of men with CH. Epidemiological data of CH in women are scarce especially in the Asian population. Here, we sought to assess the prevalence and clinical characteristics of women with CH in comparison to men in a prospective CH registry. Methods Data used in this study were obtained from the Korean Cluster Headache Registry, a prospective, cross-sectional, multicenter headache registry that collected data from consecutive patients diagnosed with CH. Demographics and clinical characteristics were compared between the sexes. Results In total, 250 patients were enrolled in this study; 41 (16.4%) were women (male to female ratio 5.1:1). Mean age of onset did not differ between women and men (30.7 +/- 15.5 vs 29.0 +/- 11.1 years). The clinical features of CH in women and men were similar, with no differences in pain severity, duration, and attack frequency. Among autonomic features, facial and forehead sweating was significantly rare in women (4.9%) compared to men with CH (33.0%). Headache-related disability assessed by Headache Impact Test-6 did not differ between the sexes; however, depression scale assessed by Patients Health Questionnaire-9 (11.0 +/- 8.5 vs 7.0 +/- 5.8, P = .009) and stress (Perceived Stress Scale 4, 7.5 +/- 3.4 vs 6.4 +/- 3.0, P = .045) were significantly higher in women with CH. Conclusions Although decreasing male preponderance was suggested in recent Western CH studies, CH in women is still far less prevalent than in men in the Korean population. Clinical and demographic characteristics were similar between the sexes. However, psychiatric comorbidities might be highly associated in women with CH.