The confirmation of a biochemical marker for women's hormonal migraine: the depo-estradiol challenge test

Lichten, Edward M.; Lichten, Jason; Whitty, Albert J.; Pieper, David R.

doi:10.1016/s0378-5122(97)88482-4

Cited by 20 publications

(25 citation statements)

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“…25 In a study of the effects of depo-estradiol injections in postmenopausal women, both history of migraine during the reproductive years and family history of migraine were predictors of migraine during estrogen therapy. 41 As opposed to a true increased risk of migraine caused by HT use, an alternative explanation for our findings might be that women who suffer from migraines are more likely to use HT. HT has been recommended as a potential treatment for migraine, particularly for those migraines that appear to be hormonally triggered or are refractory to other therapies.…”

Section: Discussionmentioning

confidence: 73%

Postmenopausal Hormone Therapy and Migraine Headache

Misakian

Langer

Benseñor

et al. 2003

Journal of Women's Health

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Section: Discussionmentioning

confidence: 73%

Postmenopausal Hormone Therapy and Migraine Headache

Misakian

Langer

Benseñor

et al. 2003

Journal of Women's Health

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“…This would explain why migraine is not associated with the transient estrogen surge at ovulation. Subsequent studies have supported the estrogen withdrawal theory as a trigger for migraine as well as confi rming the necessity of estrogen priming [17,18]. More recently, a study of 38 women with pure menstrual or menstrually-related migraine found migraine to be inversely associated with urinary estrogen levels across the menstrual cycle [19•].…”

Section: Pathophysiologymentioning

confidence: 99%

“…Estrogen withdrawal can trigger migraine in the absence of progesterone [15,16,18]. However, progesterone may play a role in modulating migraine during the luteal phase of the cycle [20].…”

Section: Pathophysiologymentioning

confidence: 99%

Migraine headache in perimenopausal and menopausal women

MacGregor

2009

Current Science Inc

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Perimenopause marks a time of change in a woman's hormonal environment, which is apparent from the resultant irregular periods and vasomotor symptoms. These symptoms can start in the early 40s and continue through to the early 50s. Migraine is also affected by hormonal fluctuations, particularly the natural decline in estrogen in the late luteal phase of the menstrual cycle. This effect of estrogen "withdrawal" on migraine appears to become more predominant during perimenopause. Despite the increased prevalence of headache and migraine in women in their 40s, migraine is underdiagnosed in this population. In women attending with symptoms suggestive of perimenopause, it is important to ask about headache symptoms. Once diagnosed, a number of strategies can be used to manage both perimenopausal migraine and menopausal symptoms effectively, with the potential to reduce the associated morbidity.

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“…34 An endogenous difference in estrogen processing in women with migraine is further supported by a study of postmenopausal women in which estrogen decline following a single injection of estradiol triggered a migraine only in women with a premenopausal history of migraine associated with menstruation. 35 This neurovulnerability to rapid estrogen decline may be due to the disruption of the serotonergic mechanisms involved in inhibition of pain leading to disruption of the trigeminovascular system. 14,36,37 Furthermore, other hormones, and particularly progesterone, may modulate the effects of estrogen on migraine.…”

mentioning

confidence: 99%

Sex hormones in women with and without migraine

et al. 2016

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Objective: To compare daily sex hormone levels and rates of change between women with history of migraine and controls.Methods: History of migraine, daily headache diaries, and daily hormone data were collected in ovulatory cycles of pre-and early perimenopausal women in the Study of Women's Health Across the Nation. Peak hormone levels, average daily levels, and within-woman day-to-day rates of decline over the 5 days following each hormone peak were calculated in ovulatory cycles for conjugated urinary estrogens (E1c), pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone. Comparisons were made between migraineurs and controls using 2-sample t tests on the log scale with results reported as geometric means.Results: The sample included 114 women with history of migraine and 223 controls. Analyses of within-woman rates of decline showed that E1c decline over the 2 days following the luteal peak was greater in migraineurs for both absolute rate of decline (33.8 [95% confidence interval 28.0-40.8] pg/mgCr vs 23.1 [95% confidence interval 20.1-26.6] pg/mgCr, p 5 0.002) and percent change (40% vs 30%, p , 0.001). There was no significant difference between migraineurs and controls in absolute peak or daily E1c, pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone levels. Secondary analyses demonstrated that, among migraineurs, the rate of E1c decline did not differ according to whether a headache occurred during the cycle studied.Conclusions: Migraineurs are characterized by faster late luteal phase E1c decline compared to controls. The timing and rate of estrogen withdrawal before menses may be a marker of neuroendocrine vulnerability in women with migraine. Neurology ® 2016;87:49-56 GLOSSARY BMI 5 body mass index; DHS 5 Daily Hormone Study; E1c 5 conjugated urinary estrogens; ELA 5 evidence of luteal activity; FSH 5 follicle-stimulating hormone; ICHD 5 International Classification of Headache Disorders; LH 5 luteinizing hormone; MHx 5 women with history of migraine; Pdg 5 pregnanediol-3-glucuronide; SWAN 5 Study of Women's Health Across the Nation.

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The confirmation of a biochemical marker for women's hormonal migraine: the depo-estradiol challenge test

Cited by 20 publications

References 0 publications

Postmenopausal Hormone Therapy and Migraine Headache

Postmenopausal Hormone Therapy and Migraine Headache

Migraine headache in perimenopausal and menopausal women

Sex hormones in women with and without migraine

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