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Defining the Relationship Between Ovarian Hormones
and Migraine Headache
Martin VT, Wernke S, Mandell K, et al.
Posted: December 2005
Objective: (1) To determine whether the
attack characteristics of migraine differ between different
intervals of the menstrual cycle; (2) To ascertain whether the "rate
of change", "magnitude of change", or "total burden" of urinary
hormone metabolites correlates with headaches outcome measures
during different intervals of the menstrual cycle.
Background: The mechanisms through which migraines
are influenced by ovarian hormones remain unclear. No previous
studies until now have identified "hormonally defined" time
intervals within the female menstrual cycle and compared headache
outcome measures among these intervals in female migraineurs.
Methods: Daily headache diary data were obtained from
21 female migraineurs during three native menstrual cycles. Daily
urine samples were collected and later assayed for estrogen and
progesterone metabolites. Seven 3-day time intervals were
identified within each menstrual cycle based on urine hormone
measurements. Primary (headache index) and secondary (disability
index, headache severity, and headache frequency) outcome measures
were compared between intervals using the mixed model approach.
"Rates of change", "magnitude of change", and the "total burden"
of ovarian hormones were estimated from urine hormone metabolites
and correlated with headache outcome measures.
Conclusions: Migraine headache is more severe,
disabling, and frequent during the menstrual intervals of the
female reproductive cycle than during mid-luteal or mid-cycle
intervals. Progesterone metabolites may play a role in modulating
migraine headaches during luteal intervals of the menstrual cycle.