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

Lactation

Lactation commonly inhibits ovulation during the postpartum period. The mean time to ovulation after delivery is 189 days in breast-feeding women and 45 days in nonbreast-feeding women.[89] The duration of anovulation may be influenced by the intensity and the frequency of breast-feeding. Seventy percent of women that practice full or partially full breast-feeding will remain amenorrheic for 6 months.[90]The "hormonal milieu" during lactation depends on the presence or absence of ovulatory cycles.

Lactation generally leads to an improvement in the clinical course of migraine headache during the postpartum time period. Sances et al[79] reported that migraine recurred within the first postpartum month in 100% of women who bottle-fed and in 43.2% of those who breast-fed (P= .0003). Marcus et al[91] found that the headache index during the first 3 postpartum months was similar for patients who breast-fed to that obtained during the second trimester of pregnancy. These data likely suggest that the improvement of migraine commonly seen during the second trimester of pregnancy continues into the postpartum time period if breast-feeding is maintained.

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