The influence of estrogen on migraine: a systematic review

JAMA : the Journal of the American Medical Association
Jan Lewis Brandes

Abstract

Menstrual migraine affects approximately 50% to 60% of female migraineurs, but knowledge regarding the role of hormones, especially estrogen, appears incomplete. To conduct a systematic review to determine the role of hormones on menstrual migraine. MEDLINE (January 1966 through September 1, 2005) and EMBASE Drugs and Pharmacology (January 1991 through September 1, 2005) were searched for articles published in the English language using the keywords migraine, estrogen, menstrual migraine, pure menstrual migraine, true menstrual migraine, menstrually-associated migraine, menstrually-related migraine, pregnancy, breast-feeding, perimenopause, menopause, nitric oxide, and estrogen receptors. A total of 643 unique articles were reviewed for relevance, scientific rigor, and generalizability. For each relevant citation, the bibliography was reviewed to identify additional sources of pertinent data. The influence of estrogen on migraine is evident by a 3-fold greater prevalence among women compared with men, and by significant changes in migraine incidence with changes in female reproductive status. Menstrual migraines are usually more resistant to treatment, generally not associated with aura, of longer duration, and associated with ...Continue Reading

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