Possible role of gonadal hormones as triggering factors in migraine

There is a large evidence that fluctuating peripheral gonadal hormones can trigger migraine attacks in women. It has been proposed that the main factor involved is a rapid fall in circulating estrogen levels. We have analysed migraine and headache attacks reported in some recent studies involving oral contraceptives and propose that also at least in a part of these cases, the withdrawal of the exogenous estrogens initiates the attack. Possible mechanisms are discussed and further studies are proposed.