Menstrual migraine is caused by estrogen withdrawal: revisiting the evidence
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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To explore and critically appraise the evidence supporting the role of estrogen withdrawal in menstrual migraine.
Main body
Menstrual migraine, impacting about 6% of reproductive-age women, manifests as migraine attacks closely related to the menstrual cycle. The estrogen withdrawal hypothesis posits that the premenstrual drop in estrogen levels serves as a trigger of migraine attacks. Despite its wide acceptance, the current body of evidence supporting this hypothesis remains limited, warranting further validation. Estrogen is believed to exert a modulatory effect on pain, particularly within the trigeminovascular system – the anatomic and physiologic substrate of migraine pathogenesis. Nevertheless, existing studies are limited by methodologic inconsistencies, small sample sizes, and variable case definitions, precluding definitive conclusions. To improve our understanding of menstrual migraine, future research should concentrate on untangling the intricate interplay between estrogen, the trigeminovascular system, and migraine itself. This necessitates the use of robust methods, larger sample sizes, and standardized case definitions to surmount the limitations encountered in previous investigations.
Conclusion
Further research is thus needed to ascertain the involvement of estrogen withdrawal in menstrual migraine and advance the development of effective management strategies to address unmet treatment needs.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 131 |
| Tidsskrift | Journal of Headache and Pain |
| Vol/bind | 24 |
| Udgave nummer | 1 |
| Antal sider | 10 |
| ISSN | 1129-2369 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
B.R. was supported by a research grant of the German Research Foundation (GZ: RA 3907/1–1). M.A. was supported by the Lundbeck Foundation Professor Grant (R310-2018-3711).
Funding Information:
B.R. reports personal fees from AbbVie, Eli Lilly, Lundbeck, Novartis, and Teva, and research grants from Novartis, all outside of the submitted work. B.R. reports serving as junior associate editor of The Journal of Headache and Pain, and associate editor of Frontiers In Neurology. T.P.D. has nothing to disclose. B.A.C. has nothing to disclose. M.A. reports receiving personal fees from AbbVie, Amgen, Eli Lilly, Lundbeck, Novartis, Pfizer and Teva Pharmaceuticals, all outside of the submitted work. MA reports serving as associate editor of Cephalalgia, associate editor of The Journal of Headache and Pain, and associate editor of Brain. F.M.A. reports personal fees from Teva, AbbVie, Pfizer, Lundbeck, Novartis and Eli Lilly, all outside of the submitted work. F.M.A. is the current President of the Danish Headache Society and a member of the Board of Directors in the European Headache Federation. F.M.A. serves as associate editor for Frontiers In Pain Research, Frontiers In Neurology, Headache Medicine, and Acta Neurologica Scandinavica; as junior associate editor for Cephalalgia, and as a member of the editorial board of the European Journal of Headache and Pain. H.A. reports personal fees from Lundbeck and Teva, outside of the submitted work.
Publisher Copyright:
© 2023, Springer-Verlag Italia S.r.l., part of Springer Nature.
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