Rapid Estrogen Decline Contributes to Migraine in Women
Researchers are narrowing in on an understanding of exactly how changes in estrogen levels play a role in migraine attacks in women. All women have a drop in estrogen levels in the days before menstruation, but women with migraine experience a more rapid estrogen drop than those without it, according to a study published in June. This could make all women with migraine—even those without menstrually-associated migraine—more vulnerable to other migraine triggers. Researchers recommend that women be extra careful to avoid migraine triggers in the few days before menstruation.
Researchers tested hormone levels in urine samples of 114 women with migraine and 223 women without migraine. Participants were premenopausal or in early perimenopause and had an average age of 47. Peak hormone levels, average daily hormone levels, and rates of decline in the five days following the peak were all tested. In women with migraine, estrogen levels dropped 40% in the days preceding menstruation; estrogen levels dropped 30% in participants without migraine. In other hormones tested (including pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone), no similar pattern was evident.
This study builds on understanding that the rate of estrogen change has a more significant impact on migraine frequency than the absolute levels of estrogen, according to Anne MacGregor, MD.
Researchers looked at women with migraine in general, not specifically at women with menstrual migraine. Women with menstrual migraine (migraine attacks only associated with the menstrual cycle) only have hormonal triggers. Findings could be different between the two groups.
REFERENCES
Pavlović, J. M., Allshouse, A. A., Santoro, N. F., Crawford, S. L., Thurston, R. C., Neal-Perry, G. S., ... & Derby, C. A. (2016). Sex hormones in women with and without migraine Evidence of migraine-specific hormone profiles. Neurology, 10-1212.
Hughes, S. (2016, Jun 3). Rapid Estrogen Decline Confirmed as Migraine Contributor. Medscape. Retrieved 7/11/16 from http://www.medscape.com/viewarticle/864251.
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