Ovarian Hormones and Migraine Headache: Understanding Mechanisms and Pathogenesis-Part I

Vincent T. Martin, MD; Michael Behbehani, PhD

Disclosures

Headache. 2006;46(1):3-23. 

In This Article

Abstract and Introduction

Ovarian hormones have a significant effect on the central nervous system of female migraineurs. Reproductive milestones such as menarche, pregnancy, and menopause are associated with changes in the clinical course of migraine headache. Migraine attacks are commonly triggered during declines in serum estrogen levels that occur before and during the time of menstruation. Therefore, substantial clinical evidence suggests that changes in ovarian hormones affect migraine headache. This represents the first of two manuscripts defining the role of ovarian hormones in the pathogenesis of migraine headache. The purpose of the first article will be to review the molecular and neurophysiologic effects of estrogen and progesterone on neurotransmitter systems and pain processing networks relevant to migraine headache. The second manuscript will focus on the clinical studies detailing the influence of estrogen and progesterone on migraine headache.

Ovarian hormones have a profound influence on the central nervous system of women. They modulate a number of neurotransmitter systems important to the pathogenesis of a variety of neurological diseases. Migraine headache in particular appears to be strongly affected by ovarian hormones. Migraine is three times more common in women than men and is modulated by changes in ovarian hormones throughout the female life span.[1] Migraine often begins during menarche, improves during the second and third trimesters of pregnancy and often remits after a long-standing menopause.[2,3] This is the first of two manuscripts defining the current knowledge of the role of ovarian hormones in the pathogenesis of migraine headache. The first manuscript will review the endocrinology of the female reproductive cycle as well as the molecular and neurophysiologic effects of estrogen and progesterone on neurotransmitter systems and pain processing networks relevant to migraine pathophysiology. The second will focus on the clinical studies detailing the influence of estrogen and progesterone on migraine headache.

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