The timing and rate of estrogen withdrawal before menses may be a marker of neuroendocrine vulnerability in women with migraine, a recent study found. History of migraine, daily headache diaries, and daily hormone data were collected by researchers in ovulatory cycles of pre- and early perimenopausal women (n=114 with history of migraine, n=223 controls). They found:

• Analyses of within-woman rates of decline showed that the decline of conjugated urinary estrogens (E1c) over the 2 days following the luteal peak was greater in those with migraine for both absolute rate of decline and percent change.

• There was no significant difference between those with migraine and controls in absolute peak or 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.

Citation: Pavlović JM, Allshouse AA, Santoro NF, et al. Sex hormones in women with and without migraine: Evidence of migraine-specific hormone profiles. [Published online ahead of print June 1, 2016]. Neurology. doi:10.1212/WNL.0000000000002798.