Case 576 · ICHD-3 8.3.3
8.3.3 Oestrogen-withdrawal headache
- Origin
- Synthetic
- Language
- English — also available in German
- Contributed by
- Imported case — HeadAI synthetic vignettes (de Andrade JBC, da Silva Costa TB, Vasconcelos JL, Lopes TLM, Balsells MD, Cristofolini VL, Querobin SO, Filho FMR. Validation of an AI-based platform for structured diagnosis of headache disorders using ICHD-3 criteria. BMC Neurology 25, 489 (2025). doi:10.1186/s12883-025-04473-1. Dataset: Andrade J. Head.AI Platform. Mendeley Data, V2 (2025). doi:10.17632/4fms6cw2s5.2)
Anamnesis
Identification: Female patient, 32 years old, using combined oral contraceptive (ethinylestradiol + levonorgestrel) for 5 years.
Clinical History:
Reports holocranial, pulsatile headache of moderate intensity, without nausea, vomiting, photophobia, or phonophobia.
Onset of pain: 2 days after the monthly medication break (7-day hormone-free interval).
Duration: 3 to 4 days, with spontaneous resolution.
Recurrent pattern: Similar episodes in the last 6 months, always during the contraceptive break.
No prior history of migraine or other primary headaches.
Complementary Exams: No abnormalities in neurological or neuroimaging exams (performed 6 months ago for initial investigation).
Report this case — e.g. suspected re-identification risk.