RT Journal Article
SR Electronic
T1 Sex hormones in women with and without migraine
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 49
OP 56
DO 10.1212/WNL.0000000000002798
VO 87
IS 1
A1 Jelena M. Pavlović
A1 Amanda A. Allshouse
A1 Nanette F. Santoro
A1 Sybil L. Crawford
A1 Rebecca C. Thurston
A1 Genevieve S. Neal-Perry
A1 Richard B. Lipton
A1 Carol A. Derby
YR 2016
UL http://n.neurology.org/content/87/1/49.abstract
AB 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.BMI=body mass index; DHS=Daily Hormone Study; E1c=conjugated urinary estrogens; ELA=evidence of luteal activity; FSH=follicle-stimulating hormone; ICHD=International Classification of Headache Disorders; LH=luteinizing hormone; MHx=women with history of migraine; Pdg=pregnanediol-3-glucuronide; SWAN=Study of Women's Health Across the Nation