Sex hormones in women with and without migraine: Evidence of migraine-specific hormone profiles
Department of Medicine, Division of Preventive and Behavioral Medicine
Nervous System Diseases | Neurology | Reproductive and Urinary Physiology | Women's Health
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.
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Citation: Neurology. 2016 Jul 5;87(1):49-56. Epub 2016 Jun 1. Link to article on publisher's site
Pavlovic, Jelena M.; Allshouse, Amanda A.; Santoro, Nanette F.; Crawford, Sybil L.; Thurston, Rebecca C.; Neal-Perry, Genevieve S.; Lipton, Richard B.; and Derby, Carol A., "Sex hormones in women with and without migraine: Evidence of migraine-specific hormone profiles" (2016). University of Massachusetts Medical School Faculty Publications. 1261.