Cluster headache (CH) occurs rarely among women; for this reason only a limited number of studies have been reported on the characteristics of the disease in the female population. In this study, 82 females (age range, 14–72 years) with episodic (69 cases) or chronic (13 cases) CH were investigated. The clinical features of headache and the physiologic events related to reproductive life were compared with those of various control groups. We did not find any remarkable differences in clinical features between men and women. Unlike other forms of primary headache, the course of CH does not seem to be modified by menstruation, pregnancy, or puerperium. Finally, our data seem to confirm a hypofertility trend, mostly after onset of CH, which had previously been noticed by other authors.