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Neurology. 2016 Jul 5;87(1):49-56. doi: 10.1212/WNL.0000000000002798. Epub 2016 Jun 1.

Sex hormones in women with and without migraine: Evidence of migraine-specific hormone profiles.

Author information

1
From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle. jpavlovi@montefiore.org.
2
From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.

Abstract

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 = 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.

PMID:
27251885
PMCID:
PMC4932235
DOI:
10.1212/WNL.0000000000002798
[Indexed for MEDLINE]
Free PMC Article

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