scholarly journals Menstrual Migraine : How Hormones Impact Migraine

2021 ◽  
Vol 5 (1) ◽  
pp. 9-17
Author(s):  
Restu Susanti ◽  
Syamel Muhammad

Menstrual Migraine is divided into 2 subtypes: Menstrually Related Migraine (MRM) and Pure Menstrual Migraines (PMM). In PMM symptoms do not occur outside the menstrual cycle while MRM, symptoms can occur at other times apart from the menstrual cycle. The occurrence of menstrual migraines is related to the female hormones cycle in the form of the decrease in estrogen levels which usually occurs a week before the onset of menstruation. The mechanism is unclear, but it is thought that a decrease in estrogen levels can trigger decrease in serotonin levels, causing cranial vasodilation and sensitization of the trigeminal nerve.  Keywords: menstrual migraine, hormones

Author(s):  
Regina Krel ◽  
Paul G. Mathew

Migraine is a common disorder that affects women of menstruating age, and it is frequently the chief complaint of women presenting in the neurology clinic. The prevalence of menstrually related migraine can range from 20–60%, while pure menstrual migraine occurs in less than 10% of women. In addition to utilizing non–gender-specific abortive and preventative strategies, understanding migraine and its relationship to hormones, particularly estrogen, can have clinical implications for optimal treatment. This chapter seeks to provide insight into diagnosing menstrually related migraine, the role of decreased estrogen just prior to menstrual cycle onset and migraine, as well as the therapeutic options that are available to treat and possibly prevent menstrual migraine attacks.


Cephalalgia ◽  
1990 ◽  
Vol 10 (6) ◽  
pp. 305-310 ◽  
Author(s):  
EA MacGregor ◽  
H Chia ◽  
RC Vohrah ◽  
M Wilkinson

Objective: To define the term “menstrual” migraine and to determine the prevalence of “menstrual” migraine in women attending the City of London Migraine Clinic. Design: Women attending the clinic were asked to keep a record of their migraine attacks and menstrual periods for at least 3 complete menstrual cycles. Results: Fifty-five women completed the study. “Menstrual” migraine was defined as “migraine attacks which occur regularly on or between days -2 to +3 of the menstrual cycle and at no other time”. Using this criterion, 4 (7.2%) of the women in our population had “menstrual” migraine. All 4 women had migraine without aura. A further 19 (34.5%) had an increased number of attacks at the time of menstruation in addition to attacks at other times of the cycle. Eighteen (32.7%) had attacks occurring throughout the cycle but with no increase in number at the time of menstruation. Fourteen (25.5%) had no attacks within the defined period during the 3 cycles studied. Discussion: A small percentage of women have attacks only occurring at the time of menstruation, which can he defined as true “menstrual” migraine. This group is most likely to respond to hormonal treatment. The group of 34.5% who have an increased number of attacks at the time of menstruation in addition to attacks at other times of the month could be defined as having “menstrually related” migraine and might well respond to hormonal therapy. The 32.7% who have attacks throughout the menstrual cycle without an increase at menstruation are unlikely to respond to hormonal therapy. The 25.5% who do not have attacks related to menstruation almost certainly will not respond to hormonal therapy.


Cephalalgia ◽  
2000 ◽  
Vol 20 (3) ◽  
pp. 148-154 ◽  
Author(s):  
S D Silberstein ◽  
G R Merriam

The normal female life cycle is associated with a number of hormonal milestones: menarche, pregnancy, contraceptive use, menopause, and the use of replacement sex hormones. All these events and interventions alter the levels and cycling of sex hormones and may cause a change in the prevalence or intensity of headache. The menstrual cycle is the result of a carefully orchestrated sequence of interactions among the hypothalamus, pituitary, ovary, and endometrium, with the sex hormones acting as modulators and effectors at each level. Oestrogen and progestins have potent effects on central serotonergic and opioid neurons, modulating both neuronal activity and receptor density. The primary trigger of menstrual migraine appears to be the withdrawal of oestrogen rather than the maintenance of sustained high or low oestrogen levels. However, changes in the sustained oestrogen levels with pregnancy (increased) and menopause (decreased) appear to affect headaches. Headaches that occur with premenstrual syndrome appear to be centrally generated, involving the inherent rhythm of CNS neurons, including perhaps the serotonergic pain-modulating systems.


Cephalalgia ◽  
1983 ◽  
Vol 3 (1_suppl) ◽  
pp. 159-162 ◽  
Author(s):  
F. Facchinetti ◽  
G. Sances ◽  
A. Volpe ◽  
D. Sola ◽  
G. D'ambrogio ◽  
...  

LH, FSH, Prolactin (PRL), Estradiol (E) and Progesterone (P) plasma levels were measured in different periods of the menstrual cycle in 15 control subjects and in 9 women suffering from perimenstrual migraine before and after prophylactic treatment with 10 mg/day dihydroergotamine (DHE) retard. LH, FSH and PRL plasma levels were similar between patients and controls and were unaffected by DHE therapy. Migraineurs showed markedly reduced P levels in the entire luteal phase, concomitantly with higher E levels, leading to a P/E ratio significantly interfering with ovarian steroids secretion. These data indicate the presence of ovarian impairment in women suffering from perimenstrual migraine, whose symptoms could be successfully treated with DHE retard without interfering with the endocrine state. Les variations cicliques de LH, FSH, Prolactine (PRL) de la Estradiol (E) et de la Progesterone (P) ont ete evaluèes chez 15 subjets temoins et chez 9 femmes souffrant de la maladie migraineuse, en conditions de base et au cours d'un traitment prophilactique avec 10 mg par jour de Dihydroergotamine (DHE) rètard. LH, FSH et PRL etaient au meme niveau chez les temoins et les patients et n'ont pas ètè modifiès par le traitment avec DHE rètard; tandis que les taux plasmatiques de la P etaient rèduites et, au contraire, ceux de la E eatient elevèes pendant toute la phase luteale des migraineuses. Par consequence le rapport P/E les patientes etait significativement inferieur que chez les temoins. Le traitment avec la DHE rètard a presque totalement prevenue les accès migraineux, sans modifier le status normonal. Les femmes souffrant de maladie migraineuse au cours du cicle menstruel, notament dans la periode premenstruelle, montrent des affections de la secretion ovarienne qui doivent etre ancore expliquées. En tous cas las symptomatologie peut etre convenablement rèlevèe par le traitment prophilactique avec DHE rètard qui d'ailleur n'a aucune influence sur les secretions hypophisaires et ovariennes. I tassi plasmatici di LH, FSH, Prolattina (PRL), Estradiolo (E) e Progesterone (P) sono stati studiati nel corso del ciclo mestruale in 15 soggetti di controllo e in 9 pazienti affette da emicrania premestruale prima e dopo un trattamento profilattico con Diidroergotamina (DHE) ritardo (10 mg/die). LH, FSH e PRL sono risultati simili nei due gruppi e non ha mostrato variazioni in seguito al trattamento. Durante l'intera fase luteale, i tassi di P delle pazienti sono risultati significativamente ridotti, mentre quelli di E al contrario, erano più elevati, rispetto a quelli dei soggetti di controllo. La terapia con DHE ha pressoché abolito l'insorgenza degli attacchi emicranici, senza interferire con le concentrazioni di E e P. In conclusione, questi dati indicano che le pazienti affette da emicrania perimestruale presentano un'alterazione della funzione ovarica che resta da definire. Il trattamento profilattico conDHE ritardo però, è risultato efficacie nella abolizione delle crisi, senza interferire con le secrezioni ormonali.


Cephalalgia ◽  
2008 ◽  
Vol 28 (12) ◽  
pp. 1277-1281 ◽  
Author(s):  
SI Bekkelund ◽  
KB Alstadhaug ◽  
R Salvesen

The aim of the study was to study seasonal variation in migraine headache in a group of women with menstrually-related migraine (MRM) compared with non-menstrual migraine. Via newspaper advertisement, women with migraine living in North Norway were invited. The patients were included by questionnaire and telephone interview. We prospectively recorded migraine attacks from a 12-month headache diary performed by a group of 62 women with a mean age of 36.0 years (range 16-46 years), who fulfilled the criteria of migraine without aura. Of these, 29 had MRM and 33 non-menstrual migraine. Mean ratio between number of attacks in the light arctic season (May-June-July) divided with total number of migraine attacks during 12 months was 0.24 (9.4/38.4) in the group of MRM compared with 0.25 (5.6/22.1) in others (confidence interval -4.2, 6.3, P = 0.84). Nor were there more migraine attacks in the dark season in an arctic area (November-December-January) in any group. We found a higher migraine attack rate in those with MRM, but no indication of more or less frequency of attacks during the bright arctic season. These findings support the assumption that MRM and seasonal variation of migraine are due to different mechanisms.


Cephalalgia ◽  
2003 ◽  
Vol 23 (9) ◽  
pp. 907-913 ◽  
Author(s):  
BM Ances ◽  
JA Detre

This pilot study investigated the effect of menstrual cycle phase (late luteal and mid-follicular) on cerebral perfusion changes during photic stimulation in both controls ( n = 5) and true menstrual migraine patients ( n = 5). No significant differences in resting baseline perfusion were observed between the two groups during either phase of the menstrual cycle. During the late luteal phase, changes in perfusion within the occipital lobe due to photic stimulation were similar for both groups. However, during the mid-follicular phase, occipital perfusion during visual stimulation decreased for controls but significantly increased for true menstrual migraine patients ( P < 0.05). A two way repeated measures ANOVA also demonstrated a significant difference between menstrual migraine patients and controls for photic activation ( P < 0.05).


Cephalalgia ◽  
1990 ◽  
Vol 10 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Fabio Facchinetti ◽  
Emilia Martignoni ◽  
Loridine Fioroni ◽  
Grazia Sances ◽  
Andrea R Genazzani

To assess the biological correlates of the precipitation of migraine attacks in the perimenstrual period, plasma b-endorphin (b-EP) and cortisol responses to naloxone (8 mg iv) and corticotropin releasing hormone (100 μg iv) were evaluated in both the follicular phase and the premenstrual period in 7 patients suffering from menstrual migraine and in 7 healthy, asymptomatic control volunteers. In the controls, naloxone evoked a significant release of both b-EP (F = 5.86, p < 0.002) and cortisol (F = 4.43, p < 0.008), independently of the menstrual cycle phase (F = 0.31 and 1.04, for b-EP and cortisol, respectively). Menstrual migraine patients, on the other hand, showed a significant hormone response only in the follicular phase, not in the premenstrual period. Corticotropin releasing hormone significantly increased b-EP and cortisol in both the controls and the menstrual migraine patients, independently of the menstrual cycle phase. In both the naloxone and corticotropin releasing hormone testings, the basal b-EP levels measured in the premenstrual period were lower than those observed in the follicular phase ( p < 0.02). These data demonstrate a cyclical, premenstrual dysfunction of the hypothalamic control exerted by opioids on the hypothalamus-pituitary-adrenal axis. Impairment of this fundamental adaptive mechanism (involved in stress responses and in pain control) could establish a causal relationship between menstrual-related migraine attacks and premenstrual opioid hyposensitivity.


2008 ◽  
Vol 48 (8) ◽  
pp. 1194-1201 ◽  
Author(s):  
Robert Nett ◽  
Lisa K. Mannix ◽  
Loretta Mueller ◽  
Anthony Rodgers ◽  
Carolyn M. Hustad ◽  
...  

Cephalalgia ◽  
1996 ◽  
Vol 16 (1) ◽  
pp. 11-21 ◽  
Author(s):  
EA MacGregor

“Menstrual” migraine, a term misused by both patients and doctors, lacks precise definition. This dissertation critically reviews papers on the subject and examines the problem from a clinical perspective. A definition is proposed that the term “menstrual” migraine should be restricted to attacks exclusively starting on or between day l ± 2 days of the menstrual cycle; the woman should be free from attacks at all other times of the cycle. This definition, unlike many used previously, links to a specific mechanism; the timing is consistent with oestrogen withdrawal. If this is correct, “oestrogen withdrawal” migraine may be a better term. Future studies, necessary to support or refute these proposals, are suggested.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Ashlesha Chaudhary

Menstrual migraine is a condition in females, where headaches are linked with menstruation and may be debilitating. Hormonal fluctuations could have a key role in migraine etiopathogenesis, as several women experience that their migraine attacks correlate with their menstrual cycle. Estrogen withdrawal appears to have a significant role in migraine associated with menstrual cycles, despite the fact that its pathophysiology is not well known. The treatment method can also vary from that used to treat nonmenstrual migraines. However, with proper identification and management of the condition, it can be bearable. This article highlights some portions of what is known about migraine, its triggers including the experience of a sufferer and aims to provide readers with a better understanding of migraine in women by understanding these aspects of the condition.


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