Ovarian Hormones and Migraine Headache: Understanding Mechanisms and Pathogenesis--Part 2

Vincent T. Martin, MD; Michael Behbehani, PhD

Disclosures

Headache. 2006;46(3):365-386. 

In This Article

Progesterone And Migraine

Progesterone and/or its metabolites as well as progestins can have a variable effect on migraine. There is preliminary evidence to suggest that mid-luteal elevations of progesterone and/or its metabolites could be preventative for migraine when compared to other times of the cycle.[16] Past studies[120,121,122,123] have also reported that daily oral progestins could be preventative for migraine headache in premenopausal women. Their preventative effect in premenopausal women may be secondary to induction of anovulation along with a preventative benefit of the particular progestin used. Side effects such as breakthrough bleeding and mastalgia may, however, limit their use. Injectable depot medroxyprogesterone and levonorgestrel implants, which are contraceptive agents, can trigger headache as a side effect in susceptible patients.[124,125] Progestins administered episodically for 10 to 12 days each month along with estrogen replacement therapy have been reported to trigger migraine in some postmenopausal women.[113,126] Therefore, progesterone and progestins can prevent or trigger migraines in different clinical situations.

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