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Hormonal Factors in Migraine:
A Population-Based Study of Women Aged 40 to 74 Years
Peter Mattsson, MD
Posted: February 2003  
Headache 2003; 43:27-35

Objectives:   This study investigated some of the relationships between migraine and hormonal factors.

Methods:  A neurologist clinically assessed 728 women aged 40 to 74 years attending a population-based mammography screening program. Headache criteria proposed by the International Headache Society were used. Data on hormonal factors were obtained by interview and questionnaire.

Results:  Twenty-one percent of women with migraine without aura and 4% of women with migraine with aura reported that they experienced >75% of their attacks within 2 to +3 days of the menstrual cycle. During pregnancy, women experienced less frequent or less intense attacks of migraine without aura and migraine with aura. A small but significant proportion (12%, P=.04) of women with migraine without aura also had premenstrual disorder. Associations between migraine and menarche, pregnancy, pregnancy-related complications, and menopausal complaints were generally weak and insignificant. Migraine with aura was not related to menopause. A crude odds ratio of 0.47 (95% confidence interval [C1] 0.24-0.86) indicated a decrease in risk for migraine without aura in postmenopausal women. However, after adjusting for differences in age and the use of hormonal replacement therapy, this association was not statistically significant. Time since menopause was a significant factor for migraine without aura in postmenopausal women.

Conclusions:  Although many women with migraine reported a close relationship between their attacks and menses, and relief during pregnancy, the cross-sectional associations between migraine and menopause and menopausal complaints were insignificant.