The influence of lifestyle and gender on cluster headache.

PURPOSE OF REVIEW: Cluster headache is by many regarded as a males' disorder that is often accompanied by an unhealthy lifestyle. We aimed to study the influence of sex and lifestyle factors on clinical presentation, the diagnostic process and management.

RECENT FINDINGS: Overall, the clinical presentation of cluster headache in both sexes was similar; however, chronic cluster headache may occur more frequently in women than in men. Misdiagnosis was most prevalent in women and more women than men were not correctly diagnosed until seen in a highly specialized center. In relation to lifestyle, smoking prevalence remains very high and some studies suggest that obesity and use of illegal drugs may be pronounced as well. In contrast to previous beliefs, recent findings on alcohol consumption report a lower use in patients than in controls. Overall, men and to some extent chronic patients were more prone to some unhealthy lifestyle factors than women and episodic patients.

SUMMARY: Despite an overall similar clinical presentation in men and women, the diagnostic process was more problematic for women in the form of more frequent misdiagnosis and failure to diagnose women in the primary and secondary sectors. Unhealthy lifestyle factors are prevalent in cluster headache and may ultimately have consequences for the management of the disease.