Impact of sex hormonal changes on tension-type headache and migraine: a cross-sectional population-based survey in 2,600 women

Abstract

Sex hormones have some implications on headaches. The objective of the study was to investigate the effects of hormonal changes comparatively on tension-type headache (TTH) and migraine, in a population-based sample. A nationwide face-to-face prevalence study was conducted using a structured electronic questionnaire. 54.3 % of the migraineurs reported that the probability of experiencing headache during menstruation was high, whereas 3.9 % had headache only during menstruation. Forward logistic regression analysis revealed that menstruation was a significant trigger for migraine in comparison to TTH. On the other hand, nearly double the number of TTH sufferers reported “pure menstrual headache” compared to migraineurs (p = 0.02). Menstrual headaches caused significantly higher MIDAS grades. One-third of the definite migraineurs reported improvement during pregnancy and oral contraceptives significantly worsened migraine. Menopause had a slight improving effect on migraine compared to TTH. Sex hormonal changes have major impacts particularly on migraine; however, the effects of hormonal fluctuations on TTH should not be underestimated.Electronic supplementary materialThe online version of this article (doi:10.1007/s10194-012-0475-0) contains supplementary material, which is available to authorized users.

Gestational headaches: characteristics and influencing factors in South-Western Nigeria

“…We equally noted a high improvement rate of 82.5% for TTH. This is higher than the improvement rate of 39.6% reported by Karli et al 14 and the rate reported previously by other authors. 18 Although the precise mechanism for this improvement is not yet elucidated, there is consensus about the role of the level of estrogen and progesterone during pregnancy and their influence on peripheral and central pain transmission via serotonergic, noradrenergic, glutamatergic, GABAergic and opioidergic neurotransmitter systems.…”

“…The modifying effects of hormone on the prevalence of migraine has been well elucidated but not so much for tension type headaches; although it is still thought, that TTH could be influenced by hormonal factors. 14 In terms of improvement, there was a significant improvement rate among the cohort of participants who had migraine and TTH before pregnancy as almost half of these patients had a complete resolution of headaches during pregnancy. The improvement we found is as previously observed with migraine headaches.…”

“…The improvement we found is as previously observed with migraine headaches. [15][16][17] While it is agreed that there is a wide migraine improvement rate of 18-80% in different studies, 14 our finding of migraine improvement rate of 100% is most likely due to the relatively small sample size of our survey. We equally noted a high improvement rate of 82.5% for TTH.…”

Role of pituitary adenylate cyclase-activating polypeptide (pacap) in the trigeminovascular system: preclinical and clinical results

“…The relation of the migraine attacks to the menstrual cycle [117] and to the presence of other non-migraine, chronic pain disorder (lumbago, low-back pain, knee-and hip-joint arthrosis) was also assessed. Depression was not clinically diagnosed in any of the cases.…”

“…Migraine attacks are often closely related to female hormonal changes [117]. Hence, it is interesting that PACAP-38-LI increases significantly during the ictal period only in those women whose headache is not related to the menstrual cycle.…”