Sex hormones in women with and without migraine

Pavlović, Jelena; Allshouse, Amanda A.; Santoro, Nanette; Crawford, Sybil L.; Thurston, Rebecca C.; Neal‐Perry, Genevieve; Lipton, Richard B.; Derby, Carol A.

doi:10.1212/wnl.0000000000002798

Cited by 103 publications

(58 citation statements)

References 43 publications

(55 reference statements)

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“…Pavlović et al provide a possible explanation for the latter and show the influences of the menstrual cycle phase and timing (65). They compared the daily sex hormone levels and within-women rates of change between females with a selfreported history of migraine and controls aged 42-52 years.…”

Section: Sex Hormonesmentioning

confidence: 99%

“…Therefore, the authors hypothesize that rapid estrogen withdrawal is not a direct trigger of migraine, but rather an endogenous characteristic and a marker for neuroendocrine vulnerability in females with migraine due to a disruption of the trigeminovascular system. Also, as progesterone has modulatory effects on estrogen in migraine, its rising levels may counteract the effects of periovulatory estrogen decline (65).…”

Section: Sex Hormonesmentioning

confidence: 99%

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Giving Researchers a Headache – Sex and Gender Differences in Migraine

et al. 2020

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Migraine is a common neurovascular disorder affecting ∼15% of the general population. Ranking second in the list of years lived with disability (YLD), people living with migraine are greatly impacted by this especially burdensome primary headache disorder. In ∼30% of individuals with migraine, transient neurological symptoms occur (migraine aura) that further increase migraine burden. However, migraine burden is differential with respect to sex. Though one-year prevalences in childhood are similar, starting with puberty, migraine incidence increases at a much higher rate in females than males. Thus, migraine over the life course occurs in women three to four times more often than in men. Attacks are also more severe in women, leading to greater disability and a longer recovery period. The sex disparity in migraine is believed to be partly mediated through fluctuations in ovarian steroid hormones, especially estrogen and progesterone, although the exact mechanisms are not yet completely understood. The release of the neuropeptide calcitonin gene-related peptide (CGRP), followed by activation of the trigeminovascular system, is thought to play a key role in the migraine pathophysiology. Given the burden of migraine and its disproportionate distribution, the underlying cause(s) for the observed differences between sexes in the incidence, frequency, and intensity of migraine attacks must be better understood. Relevant biological as well as behavioral differences must be taken into account. To evaluate the scope of the existing knowledge on the issue of biological sex as well as gender differences in migraine, we conducted a systematized review of the currently available research. The review seeks to harmonize existing knowledge on the topic across the domains of biological/preclinical, clinical, and population-level research, which are traditionally synthesized and interpreted in isolation. Ultimately, we identify knowledge gaps and set priorities for further interdisciplinary and informed research on sex and gender differences as well as gender-specific therapies in migraine.

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Section: Sex Hormonesmentioning

confidence: 99%

Section: Sex Hormonesmentioning

confidence: 99%

Giving Researchers a Headache – Sex and Gender Differences in Migraine

et al. 2020

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“…An estimated 3%–7.6% of the German and Norwegian populations experience menstrual migraine (MM) 1 2. The onset of migraine attack is pathologically associated with menstruation and could be related to drastic fluctuations in sex hormones (such as progesterone and oestrogen) throughout the menstrual cycle 3 4. The International Classification of Headache Disorders (ICHD) defined MM as migraine without aura occurring on days −2 to +3 of menstruation in at least two out of three menstrual cycles 5.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for menstrual migraine: a systematic review

Yang

Du²,

Long

et al. 2020

BMJ Support Palliat Care

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Background and objectiveIn clinical practice, the evidence of acupuncture used as a treatment for migraine without aura is employed interchangeably to guide treatment for menstrual migraine. However, its effect and safety are not substantiated. This study aimed to assess the efficacy of acupuncture on the frequency and pain intensity of menstrual migraine.MethodsWe searched PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI) and other two Chinese databases from their inception to 1 May 2019. This study included randomised controlled trials of women with menstrual migraine receiving acupuncture or a valid control. Two reviewers independently completed study selection, data extraction and risk of bias assessment. We combined data with a fixed-effect model in RevMan. Clinical outcomes included migraine frequency and duration, headache intensity, and adverse events.ResultsThirteen studies with 826 subjects were included, 9 of which had data suitable for meta-analyses. Current evidence showed that acupuncture was not superior to sham acupuncture in reducing monthly migraine frequency and duration, average headache intensity, and analgesic use at completion of treatment or follow-up. Pooled data demonstrated a significant improvement in mean headache intensity in the acupuncture group compared with drugs. However, all studies were underpowered and associated with moderate to high risk of bias. No serious adverse event was related to acupuncture treatment.ConclusionsThere is no convincing evidence to support the use of acupuncture in treating menstrual migraine. Acupuncture cannot yet be recommended to patients with menstrual migraine until more solid evidence is produced.Trial registration numberCRD42019119337.

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“…Trigger factors may interact and, acting in concert, lead to an attack. For example, the effect of stress might be greater during menses or after drinking a glass of wine . Vulnerability to trigger factors could vary over time as the threshold for migraine attacks rises and falls based upon a combination of exogenous and endogenous variables.…”

mentioning

confidence: 99%

“…For example, the effect of stress might be greater during menses or after drinking a glass of wine. 10 Vulnerability to trigger factors could vary over time as the threshold for migraine attacks rises and falls based upon a combination of exogenous and endogenous variables. To address these complexities, we need large longitudinal data sets with prospective data collection, long-term follow-up periods, and sophisticated modeling approaches.…”

mentioning

confidence: 99%