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Semin Neurol 2006; 26(2): 217-222
DOI: 10.1055/s-2006-939922
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Special Considerations in the Treatment of Migraine in Women

Christine L. Lay1 , Susan W. Broner1
  • 1The Headache Institute, St. Luke's-Roosevelt Hospital Center, New York, New York
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Publication History

Publication Date:
21 April 2006 (online)

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ABSTRACT

Nearly 32 million Americans have migraine, 24 million of whom are women who suffer with migraine throughout their lifetimes. Prior to puberty, girls are afflicted with migraine at approximately the same rate as boys, but after puberty there is an emerging female predominance. Although hormones do not entirely explain the epidemiological variation seen in migraine, estrogen certainly plays an important role. Given the hormonal changes occurring throughout a woman's life, there are many opportunities for a hormonal impact on migraine, including menarche, oral contraceptive use, pregnancy, perimenopause, and menopause. The special considerations of migraine in women will be reviewed including epidemiology, pathophysiology, diagnosis, and therapy.

KEYWORDS

Hormones - menstrual migraine - pregnancy - menopause - contraceptives

REFERENCES

  • 1 Van der Linden J A. De Hemicrania Menstrua. London; Elsevirium 1666
    Google Scholar
  • 2 Allais G, Benedetto C. Update on menstrual migraine: from clinical aspects to therapeutical strategies.  Neurol Sci. 2004;  25(suppl 3) S229-S231
    CrossrefPubMedGoogle Scholar
  • 3 Epstein M T, Hockaday J M, Hockaday T D. Migraine and reproductive hormones throughout the menstrual cycle.  Lancet. 1975;  1 543-548
    PubMedGoogle Scholar
  • 4 MacGregor E A. Oestrogen and attacks of migraine with and without aura.  Lancet Neurol. 2004;  3 354-361
    PubMedGoogle Scholar
  • 5 Couturier E G, Bomhof M A, Neven A K, van Duijn N P. Menstrual migraine in a representative Dutch population sample: prevalence, disability and treatment.  Cephalalgia. 2003;  23 302-308
    CrossrefPubMedGoogle Scholar
  • 6 Granella F, Sances G, Allais G et al.. Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centers.  Cephalalgia. 2004;  24 707-716
    CrossrefPubMedGoogle Scholar
  • 7 Headache Classification Subcommittee of the International Headache Society . The International Classification of Headache Disorders, 2nd edition.  Cephalalgia. 2004;  24(suppl 1) 139-140
    PubMedGoogle Scholar
  • 8 Silberstein S D, Merriam G R. Sex hormones and headache.  J Pain Symptom Manage. 1993;  8 98-114
    CrossrefPubMedGoogle Scholar
  • 9 MacGregor E A. “Menstrual” migraine: towards a definition.  Cephalalgia. 1996;  16 11-21
    CrossrefPubMedGoogle Scholar
  • 10 Johnson S R. Premenstrual syndrome, premenstrual dysphoric disorder, and beyond: a clinical primer for practitioners.  Obstet Gynecol. 2004;  104 845-859
    PubMedGoogle Scholar
  • 11 Somerville B W. The role of estradiol withdrawal in the etiology of menstrual migraine.  Neurology. 1972;  22 355-365
    PubMedGoogle Scholar
  • 12 Somerville B W. Estrogen-withdrawal migraine.  Neurology. 1975;  25 239-250
    CrossrefPubMedGoogle Scholar
  • 13 Sargent J, Solbach P, Damasio H et al.. A comparison of naproxen sodium to propranolol hydrochloride and a placebo control for the prophylaxis of migraine headache.  Headache. 1985;  25 320-324
    PubMedGoogle Scholar
  • 14 Al-Waili N S. Treatment of menstrual migraine with prostaglandin synthesis inhibitor mefenamic acid: double-blind study with placebo.  Eur J Med Res. 2000;  5 176-182
    PubMedGoogle Scholar
  • 15 Newman L C, Lipton R B, Lay C L, Solomon S. A pilot study of oral sumatriptan as intermittent prophylaxis of menstruation-related migraine.  Neurology. 1998;  51 307-309
    CrossrefPubMedGoogle Scholar
  • 16 Newman L, Mannix L K, Landy S et al.. Naratriptan as short-term prophylaxis of menstrually associated migraine: a randomized, double-blind, placebo-controlled study.  Headache. 2001;  41 248-256
    CrossrefPubMedGoogle Scholar
  • 17 Silberstein S D, Elkin A H, Schreiber C, Keywood C. A randomized trial of frovatriptan for the intermittent prevention of menstrual migraine.  Neurology. 2004;  63 261-269
    CrossrefPubMedGoogle Scholar
  • 18 Edelson R N. Menstrual migraine and other hormonal aspects of migraine.  Headache. 1985;  25 376-379
    CrossrefPubMedGoogle Scholar
  • 19 Silberstein S D, Bradley K. DHE-45® in the prophylaxis of menstrually related migraine. Platform presentation at the IX Migraine Trust International Symposium, London, UK, September 1996 Cephalagia 1996 16:371
    Google Scholar
  • 20 D'Alessandro R, Gamberini G, Lozito A, Sacquegna T. Menstrual migraine: intermittent prophylaxis with a timed-release pharmacological formulation of dihydroergotamine.  Cephalalgia. 1983;  3(suppl 1) 156-158
    PubMedGoogle Scholar
  • 21 Silberstein S D. The role of sex hormones in headache.  Neurology. 1992;  42(suppl 2) 37-42
    PubMedGoogle Scholar
  • 22 Dennerstein L, Morse C, Burrows G et al.. Menstrual migraine: a double-blind trial of percutaneous estradiol.  Gynecol Endocrinol. 1988;  2 113-120
    PubMedGoogle Scholar
  • 23 de Lignieres B, Vincens M, Mauvais-Jarvis P et al.. Prevention of menstrual migraine by percutaneous oestradiol.  Br Med J (Clin Res Ed). 1986;  293 1540
    PubMedGoogle Scholar
  • 24 Calton G J, Burnett J W. Danazol and migraine.  N Engl J Med. 1984;  310 721-722
    PubMedGoogle Scholar
  • 25 O'Dea J P, Davis E H. Tamoxifen in the treatment of menstrual migraine.  Neurology. 1990;  40 1470-1471
    PubMedGoogle Scholar
  • 26 Herzog A G. Continuous bromocriptine therapy in menstrual migraine.  Neurology. 1997;  48 101-102
    PubMedGoogle Scholar
  • 27 Holdaway I M, Parr C E, France J. Treatment of a patient with severe menstrual migraine using the depot LHRH analogue Zoladex.  Aust NZJ Obstet Gynaecol. 1991;  31 164-165
    PubMedGoogle Scholar
  • 28 Murray S C, Muse K N. Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and “add-back” therapy.  Fertil Steril. 1997;  67 390-393
    CrossrefPubMedGoogle Scholar
  • 29 Neri I, Granella F, Nappi R et al.. Characteristics of headache at menopause: a clinico-epidemiologic study.  Maturitas. 1993;  17 31-37
    CrossrefPubMedGoogle Scholar
  • 30 Martin V, Wenke S, Mandell K et al.. Medical oophorectomy with and without estrogen add-back therapy in the prevention of migraine headache.  Headache. 2003;  43 309-321
    CrossrefPubMedGoogle Scholar
  • 31 Dalton K. Migraine and oral contraceptives.  Headache. 1976;  15 247-251
    CrossrefPubMedGoogle Scholar
  • 32 Bousser M G, Conard J, Kittner S et al.. Recommendations on the risk of ischaemic stroke associated with use of combined oral contraceptives and hormone replacement therapy in women with migraine. The International Headache Society Task Force on Combined Oral Contraceptive and Hormone Replacement Therapy.  Cephalalgia. 2000;  20 155-156
    CrossrefPubMedGoogle Scholar
  • 33 Fox A W, Davis R L. Migraine chronobiology.  Headache. 1998;  38 436-441
    CrossrefPubMedGoogle Scholar
  • 34 Sances G, Granella F, Nappi R E et al.. Course of migraine during pregnancy and postpartum: a prospective study.  Cephalalgia. 2003;  23 197-205
    CrossrefPubMedGoogle Scholar
  • 35 Silberstein S D. Headaches and women: treatment of the pregnant and lactating migraineur.  Headache. 1993;  33 533-540
    CrossrefPubMedGoogle Scholar
  • 36 Pfaffenrath V, Rehm M. Migraine in pregnancy: what are the safest treatment options?.  Drug Saf. 1998;  19 383-388
    CrossrefPubMedGoogle Scholar
  • 37 Cupini L M, Matteis M, Troisi E, Calabresi P, Bernardi G, Silvestrini M. Sex hormone related events in migrainous females: a clinical comparative study between migraine with aura and migraine without aura.  Cephalalgia. 1995;  15 140-144
    CrossrefPubMedGoogle Scholar
  • 38 Wainscott G, Sullivan F M, Volans G N, Wilkinson M. The outcome of pregnancy in women suffering from migraine.  Postgrad Med J. 1978;  54 98-102
    CrossrefPubMedGoogle Scholar
  • 39 Fox A W, Chambers C D, Anderson P O, Diamond M L, Spierings E LH. Evidence-based assessment of pregnancy outcome after sumatriptan exposure.  Headache. 2002;  42 8-15
    CrossrefPubMedGoogle Scholar
  • 40 MacGregor E A. Effects of oral and transdermal estrogen replacement on migraine.  Cephalalgia. 1999;  19 124-125
    CrossrefPubMedGoogle Scholar
  • 41 Facchinetti F, Nappi R E, Tirelli A et al.. Hormone supplementation differently affects migraine in postmenopausal women.  Headache. 2002;  42 924-929
    CrossrefPubMedGoogle Scholar
  • 42 Hodson J, Thompson J, al-Azzawi F. Headache at menopause and in hormone replacement therapy users.  Climacteric. 2000;  3 119-124
    PubMedGoogle Scholar
  • 43 Nappi R E, Cagnacci A, Granella F et al.. Course of primary headaches during hormone replacement therapy.  Maturitas. 2001;  38 157-163
    CrossrefPubMedGoogle Scholar

Christine L LayM.D. 

The Headache Institute, St. Luke's-Roosevelt Hospital Center

1000 Tenth Avenue, Suite 1C-10, New York, NY 10019