New research published in November 2022 highlights the key role of sex hormones in migraine , especially in women. These results enrich the data of our previous article on migraine in female genital life .
This cross-sectional study was conducted at Government Medical College, Kota, India to investigate the relationship between hormone levels and symptoms in patients with migraine with aura (M+A), migraine without aura (MA) and other types of headaches. Forty patients were evaluated, including 11 M+A, 24 MA and 5 other headache types. Most patients (68%) were female, with a mean age of approximately 36 years.
Estrogens influence migraine
The researchers assessed hormone levels in all 3 groups and observed the following:
Most AD patients had low estrogen levels (67%), most M+A patients had high estrogen levels (82%), and most other headache types had estrogen levels normal (80%; p<0.001).
Most AD patients (88%) had normal prolactin* levels, but those with M+A (64%) and other headache types (80%; p=0.001) had elevated prolactin levels.
No significant features were observed in the groups for progesterone , testosterone , follicle-stimulating hormone, luteinizing hormone, or TSH on the influence of migraines.
The impact of alcohol and tobacco
The researchers then looked at the lifestyle habits of the three groups and found that:
M+A patients were more likely to drink alcohol (64% vs. MA 21% vs. 0% others; p=0.011); tobacco use was similar between groups.
Alcohol and tobacco are common triggers for migraine .
Alcohol consumption was associated with higher estrogen levels (p = 0.002), particularly in women (p = 0.011). Smoking was associated with lower estrogen levels (p=0.001), particularly in women (p=0.034).
The role of pregnancy and contraceptives on migraines
Finally, the researchers conducted a detailed examination of the patients and found the following:
Among women who had been pregnant before, most (70%) reported improvement or resolution of symptoms during pregnancy , while 20% had no change and 10% had worsening symptoms (p = 0, 03).
Similarly, among women who had ever received a combined oral contraceptive (COC), the majority (70%) reported an improvement or resolution of headache symptoms while using the COC, while 10% did not. had no change and 20% experienced worsening of migraine symptoms (p=0.04).
Conclusion of the study
The researchers concluded that estrogen is a key factor in M+A and AD, especially in women.
They point to some therapeutic implications of their work, including the potential for estrogen manipulation (supplementation in AD, antagonism in M+A) and lifestyle modification (avoidance of alcohol and smoking) to help reduce the migraine burden.
*prolactin is a hormone mainly involved in the production of breast milk