Headache, migraine, cutaneous allodynia, and mental health symptoms among Brazilian medical students: a cross-sectional study

ObjectiveTo estimate the prevalence of headache and migraine among medical students in Brazil and analyze associations between headache burden, disability, cutaneous allodynia, depressive/anxiety symptoms, andhormonal factors.MethodsThis cross-sectional study included 135 medical students from UNIFIPA/FAMECA, surveyed via selfadministeredelectronic questionnaire (October 2024-March 2025). Headache was classified per ICHD-3 criteria; disability, impact, allodynia, and depressive/anxiety symptoms were assessed using validated Brazilian-Portuguese MIDAS, HIT-6, ASC-12, BDI-I, and BAI.ResultsMean age was 21.9 (±2.03) years. Recurrent headache was reported by 54.8% (n=74/135; 95% CI 46.0-63.4%), with higher odds in females than males (62.2% vs. 43.4% ; p=0.032, OR = 2.15, 95% CI 1.06-4.33). Migraine spectrum disorders accounted for 81.1% (n=60/74), probable migraine being most frequent. Depressive and anxiety symptom severities did not differ significantly between participants with and without headache (p=0.563 and p=0.484, respectively). Females showed higher depressive (p=0.019) and anxiety symptom severity (p<0.001). Cutaneous allodynia was strongly associated with severe functional impact (p<0.001) and disability (p=0.005). Among symptomatic females (n=51), 51.0% (n=26) reported a perimenstrual relationship, and 75.5% (n=40/53) reported Premenstrual Syndrome (PMS). Five of six women with migraine with aura (83.3%) used combined hormonal contraceptives.ConclusionsHeadache disorders, particularly migraine spectrum disorders, were highly prevalent among medical students. Female sex, cutaneous allodynia, and depressive/anxiety symptoms were relevant markers of burden. Combined hormonal contraceptive use among most women with migraine with aura highlights a gap in headache-informed counseling, reinforcing the need for systematic screening, mental health support, and safety education in university health services.