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Sex hormones and headache.

S D Silberstein1

  • 1Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Stephen.Silberstein@mail.tju.edu

Revue Neurologique
|January 5, 2001
PubMed
Summary

Hormonal changes during a woman's life, including menstruation, pregnancy, and menopause, significantly impact migraine frequency and intensity. Estrogen withdrawal is a key trigger for menstrual migraine (MM), necessitating tailored treatment approaches.

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Area of Science:

  • Neurology
  • Endocrinology
  • Women's Health

Background:

  • Female hormonal milestones like menarche, pregnancy, menopause, and therapeutic hormone use alter sex hormone levels.
  • These hormonal fluctuations can influence the prevalence and intensity of headaches, particularly migraines.
  • Sex hormones, estrogen and progestins, modulate central nervous system activity, affecting neuronal pathways involved in pain perception.

Purpose of the Study:

  • To explore the intricate relationship between female sex hormones and migraine.
  • To provide a logical treatment framework for headaches linked to menstrual cycles, menopause, and oral contraceptive (OC) use.
  • To understand the triggers and characteristics of menstrually-related migraine (MM).

Main Methods:

  • Review of existing literature on hormonal influences on migraine.
  • Analysis of the role of estrogen and progesterone in headache pathophysiology.
  • Examination of the impact of hormonal events (menarche, pregnancy, menopause) and interventions (OCs, HRT) on migraine patterns.

Main Results:

  • Estrogen withdrawal is identified as a primary trigger for menstrually-related migraine (MM).
  • Migraine prevalence is significantly higher in adult women than men, often starting in adolescence.
  • Pregnancy may improve migraine for some due to sustained high estrogen levels, while hormonal replacement therapy and OCs can alter migraine frequency and character.

Conclusions:

  • Headaches associated with hormonal changes are complex and often difficult to treat.
  • Understanding the role of sex hormones is crucial for developing effective abortive and preventive migraine therapies.
  • Tailored treatment strategies, including hormonal manipulation, are essential for managing migraines related to the female life cycle.

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