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Effect of testosterone therapy on migraine frequency and disability in two transgender patients: a case report
  1. Candice Marie Todd1,2,
  2. Amy Yu3,
  3. Christine Lay1 and
  4. Ana Marissa Lagman-Bartolome1,4
  1. 1Centre for Headache, Women's College Hospital, Toronto, Ontario, Canada
  2. 2Division of Neurology, Adult Neurology Fellowship Program, University of Toronto, Toronto, Ontario, Canada
  3. 3Medicine, University of Ottawa, Ottawa, Ontario, Canada
  4. 4Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
  1. Correspondence to Dr Candice Marie Todd; candice.todd{at}


With an increasing number of patients seeking gender-affirming hormone therapy (GAHT), the clinical impact of testosterone treatments on headache needs to be determined. Our case report looks at the potential effect of testosterone on migraine among transgender patients. We present two transmasculine patients who used masculinising hormone therapy with testosterone. Both patients described their headache as moderate-to-severe pain with features that fulfilled the criteria for chronic migraine without aura. Following GAHT, one patient improved in both frequency and intensity of headache symptoms while the other noted improvement in headache intensity alone. Our report postulates that testosterone therapy may have a positive impact on headaches in individuals participating in GAHT, highlighting the need for further research on the role of testosterone therapy on headache in transmasculine individuals.

  • Headache (including migraines)
  • Pain (neurology)

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  • Contributors Conception and design: CMT, AY, CL and AML-B. Acquisition of data, analysis and interpretation of data: CMT, CL and AML-B. Drafting the article or revising it critically for important intellectual content: CMT, AY, CL and AML-B. Final approval of the version published: CMT, AY, CL and AML-B. Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved: CMT, AY, CL and AML-B.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.