Hormones Matter TM

The Monthly Migraine

November 28, 2011  |  Hormone Stories

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If about once a month, along with you menstrual cycle, you develop a pounding and often incapacitating head pain, you are not alone.  According to some studies, menstruation is a trigger for up to 60% of women who suffer with migraine.  Migraine, as defined by the International Headache Society, is an intense, throbbing headache with light or sound sensitivity, worsened by movement and with nausea or vomiting.  Judging by how common menstrual related migraine is, it seems clear that there is a relationship with the biologic changes during menstruation and the body’s processes that cause migraine.  What is not so clear is exactly why this happens.

Research over the last several decades has uncovered that migraine is caused by a complicated interaction between the brain and blood vessels in the head. Abnormal changes in levels of substances that are naturally produced in the brain can cause inflammation. This inflammation then causes blood vessels in the brain to swell and press on nearby nerves, causing pain.  Various changes in different regions of the brain account for the sensory hypersensitivity and other symptoms of migraine.

Because migraine is such a common neurologic disorder, affecting up to 28 million Americans, it is very unlikely that there is just one cause to migraine.  Population studies suggest that migraine runs in families.  Recently, there have been dozens of genes discovered which have been associated with migraine.  More than likely, there are many genes yet to be found.  The currently known genes seem to have effects on widely different parts of the brain.   When these genetically susceptible people are exposed to a combination of triggers, specific regions of brain can become activated and set of a migraine.  Triggers can come from outside the body (like certain foods, flashing lights and loud sounds) or they can come from inside the body (like menstruation, sleep difficulties or stress).    One way to think about the symptoms of migraine is to see them as the common end result of a vast variety of changes which can occur in the brain of a genetically predisposed person.

Studies show that approximately 18% of women and 6% of men experience migraine.  Interestingly, prior to the onset of adolescence, boys seem to have a slightly higher prevalence of migraine.  Based upon the available research, hormones have been strongly implicated in causing this gender schism.

All throughout a woman’s hormonal life, migraines can play a significant role.  They can occur with ovulation and a few days before or during menstruation.  Most women improve with pregnancy, but for some, migraines worsen. About two-thirds of women with migraines report that their symptoms improve with natural menopause; however, surgical menopause results in worsening of migraine in two-thirds of women.  It is obvious that the role hormones play in precipitating migraine is not a simple one.

Animal experiments have shown that estradiol and progesterone, during different phases of the menstrual cycle, can cause some regions of the brain associated with migraine to be much more active.  Clinically, it has been demonstrated that some women can decrease the frequency of migraine attacks by using estrogen and progesterone supplements in the form of oral contraceptives pills.  Notably though, not all women benefit from this; in fact, many women actually get worse.  Estrogen and progesterone alone are unlikely to be solely responsible in increasing the prevalence of migraine in women.  Throughout an adult woman’s life, there is a complicated choreography of many hormones like estrone, estriol, testosterone, DHEA and DHEAS, to name a few; however, their roles have yet to be investigated in migraine.

Fortunately, groups like Lucine Biotech have come together to help further the understanding of the intricate interplay of hormones and complicated medical issues like migraine. The eventual goal is be able to offer personalized lines of medical intervention based upon an individual’s unique hormonal patterns.  Until then, if migraines are playing a significant role in your life, you should speak to your physician because there are many medications and lifestyle modifications which can help you gain control over your migraine problem.