The role of sex hormones in headache

Silberstein, Stephen D. MD

From Temple University School of Medicine, and the Comprehensive Headache Center at The Germantown Hospital and Medical Center, Philadelphia, Pennsylvania.

Address correspondence and reprint requests to Dr. Stephen D. Silberstein, One Penn Boulevard, Philadelphia, PA 19144.

Neurology 42(3):p 37-42, March 1992.

Article abstract

Changes in estrogen levels at menarche, menstruation, pregnancy, and menopause may trigger or change the prevalence of migraine. The fall in estrogen that occurs with menstruation is the trigger for menstrual migraine, whereas the sustained high estrogen levels during pregnancy frequently result in headache relief. Estrogen produces changes in prostaglandins, hypothalmic opioids, and prolactin secretion, which may in part account for genesis of headache. The treatment of menstrual migraine and migraine associated with menopause and the use of oral contraceptives is discussed, focusing on standard headache treatment and hormonal manipulation.