Sex Hormones and Migraine

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On August 14 Dr. John Rothrock, vice chair of neurology at George Washington University and editor of Migraineur, appeared on Washington, DC's Fox News at 5 to discuss new research investigating how the sex hormones, estrogen and testosterone, may influence migraine in both males and females.  

It has long been known that migraine afflicts women more often than men.  Rothrock noted that the prevalence of migraine is more or less equal in males and females prior to puberty.  Following the onset of puberty, however, the prevalence of migraine in females rises rapidly to become 3 times that of the prevalence in males.  This imbalance persists until menopause, when the prevalence rates gradually drift back to become roughly equivalent. 

Rothrock also noted that about 70% of cycling females of childbearing potential who have migraine report menstrual worsening of their migraine, and this worsening appears to correlate with the drop in estrogen levels associated with menses.  

Recent research has indicated that the "circuitry" of migraine which resides in the lining of the brain contains cellular receptors that are quite sensitive to fluctuations in the levels of estrogen and progesterone.  "This may explain how the sex hormones influence clinical expression of migraine and, given the fluctuation in sex hormone levels that occurs in females, why there exists such a marked gender discrepancy in migraine prevalence," Rothrock proposed.  He added that the identification of these receptors could provide new targets for therapies intended to suppress migraine.  

Other recent research involving migraine and the sex hormones has indicated that males with migraine may have elevated levels of estrogen relative to migraine-free males.  "These findings are interesting but quite preliminary," Rothrock concluded, “and the number of subjects involved in this single study was rather small.  The results require confirmation via a larger investigation."  

This and other information related to the role hormones play in promoting or suppressing migraine may be found in the latest issue of Migraineur, download the complete issue now.

Download Migraineur, Summer 2018 >