Advertisement

Der Schmerz

, Volume 22, Supplement 1, pp 31–36 | Cite as

Migräne und Hormone: Was ist gesichert?

  • U. Bingel
Übersichten

Zusammenfassung

Frauen leiden häufiger an Migräne als Männer. Dieses Ungleichgewicht ist bei gleicher genetischer Disposition u. a. in zusätzlichen Triggerfaktoren wie den natürlichen Schwankungen im weiblichen Hormonhaushalt begründet. Der Einfluss der weiblichen Geschlechtshormone auf Migräne wird neben der unterschiedlichen Häufigkeiten der Migräne von Männern und Frauen durch die fluktuierende Migräneprävalenz innerhalb des Lebens und des monatlichen Hormonzyklus der Frau illustriert. Dazu gehören das Phänomen der menstruellen Migräne, der überwiegend positive Verlauf der Migräne bei stabilen Hormonverhältnissen wie in Schwangerschaft, Stillzeit und nach der Menopause, sowie der Einfluss exogen zugeführter Hormone wie der Pille oder einer postmenopausalen Hormonersatztherapie auf die Migränefrequenz. Zusammenfassend bekräftigen epidemiologische, klinische und experimentelle Untersuchungen einen wesentlichen Einfluss der weiblichen Geschlechtshormone auf die Pathophysiologie der Migräne.

Schlüsselwörter

Kopfschmerzen Hormone Migräne Schwangerschaft Menopause Menstruelle Migräne 

Migraine and hormones: what can we be certain of?

Abstract

Women suffer from migraine far more frequently than men. This sex difference during the reproductive years is considered to result from additional trigger factors, such as the fluctuating hormones of the menstrual cycle and with the reproductive milestones of women. The role of the female hormones on migraine is illustrated by the phenomenon of menstrual migraine, and the changes in the clinical course of migraine with menarche, pregnancy, menopause and the external application of hormones. In summary, epidemiological, clinical and experimental studies document a substantial influence of female sex hormones on the pathophysiology of migraine headache.

Keywords

Headache Hormones Migraine Pregnancy Menopause Menstrual migraine 

Notes

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Dzoljic E, Sipetic S, Vlajinac H et al. (2002) Prevalence of menstrually related migraine and nonmigraine primary headache in female students of Belgrade university. Headache 42: 185–193PubMedCrossRefGoogle Scholar
  2. 2.
    Couturier EG, Bomhof MA, Neven AK, van Duijn NP (2003) Menstrual migraine in a representative Dutch population sample: prevalence, disability and treatment. Cephalalgia 23: 302–308PubMedCrossRefGoogle Scholar
  3. 3.
    Granella F, Sances G, Zanferrari C et al. (1993) Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache 33: 385–389PubMedCrossRefGoogle Scholar
  4. 4.
    MacGregor EA, Chia H, Vohrah RC, Wilkinson M (1990) Migraine and menstruation: a pilot study. Cephalalgia 10: 305–310PubMedCrossRefGoogle Scholar
  5. 5.
    Johannes CB, Linet MS, Stewart WF et al. (1995) Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology 45: 1076–1082PubMedGoogle Scholar
  6. 6.
    MacGregor EA, Frith A, Ellis J et al. (2006) Incidence of migraine relative to menstrual cycle phases of rising and falling estrogen. Neurology 67: 2154–2158PubMedCrossRefGoogle Scholar
  7. 7.
    Stewart WF, Lipton RB, Chee E et al. (2000) Menstrual cycle and headache in a population sample of migraineurs. Neurology 55: 1517–1523PubMedGoogle Scholar
  8. 8.
    Rasmussen BK, Olesen J (1992) Migraine with aura and migraine without aura: an epidemiological study. Cephalalgia 12: 221–228; discussion 186PubMedCrossRefGoogle Scholar
  9. 9.
    Granella F, Sances G, Pucci E et al. (2000) Migraine with aura and reproductive life events: a case control study. Cephalalgia 20: 701–707PubMedCrossRefGoogle Scholar
  10. 10.
    Granella F, Sances G, Allais G et al. (2004) Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centres. Cephalalgia 24: 707–716PubMedCrossRefGoogle Scholar
  11. 11.
    Dowson AJ, Kilminster SG, Salt R (2005) Disability associated with headaches occurring inside and outside the menstrual period in those with migraine: a general practice study. Headache 45: 274–282PubMedCrossRefGoogle Scholar
  12. 12.
    MacGregor EA, Hackshaw A (2004) Prevalence of migraine on each day of the natural menstrual cycle. Neurology 63: 351–353PubMedGoogle Scholar
  13. 13.
    Somerville BW (1971) The role of progesterone in menstrual migraine. Neurology 21: 853–859PubMedGoogle Scholar
  14. 14.
    Somerville BW (1972) The role of estradiol withdrawal in the etiology of menstrual migraine. Neurology 22: 355–365PubMedGoogle Scholar
  15. 15.
    Somerville BW (1975) Estrogen-withdrawal migraine. II. Attempted prophylaxis by continuous estradiol administration. Neurology 25: 245–250PubMedGoogle Scholar
  16. 16.
    Somerville BW (1975) Estrogen-withdrawal migraine. I. Duration of exposure required and attempted prophylaxis by premenstrual estrogen administration. Neurology 25: 239–244PubMedGoogle Scholar
  17. 17.
    Nagel-Leiby S, Welch KM, Grunfeld S, D’Andrea G (1990) Ovarian steroid levels in migraine with and without aura. Cephalalgia 10: 147–152PubMedCrossRefGoogle Scholar
  18. 18.
    Facchinetti F, Bonellie G, Kangasniemi P et al. (1995) The efficacy and safety of subcutaneous sumatriptan in the acute treatment of menstrual migraine. The Sumatriptan Menstrual Migraine Study Group. Obstet Gynecol 86: 911–916PubMedCrossRefGoogle Scholar
  19. 19.
    Loder E, Silberstein SD, Abu-Shakra S et al. (2004) Efficacy and tolerability of oral zolmitriptan in menstrually associated migraine: a randomized, prospective, parallel-group, double-blind, placebo-controlled study. Headache 44: 120–130PubMedCrossRefGoogle Scholar
  20. 20.
    Mannix LK, Loder E, Nett R et al. (2007) Rizatriptan for the acute treatment of ICHD-II proposed menstrual migraine: two prospective, randomized, placebo-controlled, double-blind studies. Cephalalgia 27: 414–421PubMedCrossRefGoogle Scholar
  21. 21.
    Allais G, Acuto G, Cabarrocas X et al. (2006) Efficacy and tolerability of almotriptan versus zolmitriptan for the acute treatment of menstrual migraine. Neurol Sci 27 [suppl 2]: S193–S197Google Scholar
  22. 22.
    Massiou H, Jamin C, Hinzelin G, Bidaut-Mazel C (2005) Efficacy of oral naratriptan in the treatment of menstrually related migraine. Eur J Neurol 12: 774–781PubMedCrossRefGoogle Scholar
  23. 23.
    Brandes JL, Kudrow D, Stark SR et al. (2007) Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA 297: 1443–1454PubMedCrossRefGoogle Scholar
  24. 24.
    Benedetto C (1989) Eicosanoids in primary dysmenorrhea, endometriosis and menstrual migraine. Gynecol Endocrinol 3: 71–94PubMedCrossRefGoogle Scholar
  25. 25.
    Allais G, Bussone G, De Lorenzo C et al. (2007) Naproxen sodium in short-term prophylaxis of pure menstrual migraine: pathophysiological and clinical considerations. Neurol Sci 28 [suppl 2]: S225–S228Google Scholar
  26. 26.
    Sances G, Martignoni E, Fioroni L et al. (1990) Naproxen sodium in menstrual migraine prophylaxis: a double-blind placebo controlled study. Headache 30: 705–709PubMedCrossRefGoogle Scholar
  27. 27.
    Szekely BC (1991) Naproxen for perimenstrual headache. Headache 31: 345PubMedCrossRefGoogle Scholar
  28. 28.
    Von Seggern RL, Mannix LK, Adelman JU (2004) Rofecoxib in the prevention of perimenstrual migraine: an open-label pilot trial. Headache 44: 160–165CrossRefGoogle Scholar
  29. 29.
    Moschiano F, Allais G, Grazzi L et al. (2005) Naratriptan in the short-term prophylaxis of pure menstrual migraine. Neurol Sci 26 [suppl 2]: s162–s166Google Scholar
  30. 30.
    Newman L, Mannix LK, Landy S et al. (2001) Naratriptan as short-term prophylaxis of menstrually associated migraine: a randomized, double-blind, placebo-controlled study. Headache 41: 248–256PubMedCrossRefGoogle Scholar
  31. 31.
    Silberstein SD, Elkind AH, Schreiber C, Keywood C (2004) A randomized trial of frovatriptan for the intermittent prevention of menstrual migraine. Neurology 63: 261–269PubMedGoogle Scholar
  32. 32.
    Newman LC, Lipton RB, Lay CL, Solomon S (1998) A pilot study of oral sumatriptan as intermittent prophylaxis of menstruation-related migraine. Neurology 51: 307–309PubMedGoogle Scholar
  33. 33.
    Mannix LK, Savani N, Landy S et al. (2007) Efficacy and tolerability of naratriptan for short-term prevention of menstrually related migraine: data from two randomized, double-blind, placebo-controlled studies. Headache 47: 1037–1049PubMedCrossRefGoogle Scholar
  34. 34.
    Pfaffenrath V (1993) Efficacy and safetey of percutaeous estradiol vs. placebo in menstrual migraine. Cephalalgia 13 [suppl]: 244Google Scholar
  35. 35.
    Smits MG, van der Meer YG, Pfeil JP et al. (1994) Perimenstrual migraine: effect of estraderm TTS and the value of contingent negative variation and exteroceptive temporalis muscle suppression test. Headache 34: 103–106PubMedCrossRefGoogle Scholar
  36. 36.
    Macgregor EA, Hackshaw A (2002) Prevention of migraine in the pill-free interval of combined oral contraceptives: a double-blind, placebo-controlled pilot study using natural oestrogen supplements. J Fam Plann Reprod Health Care 28: 27–31PubMedCrossRefGoogle Scholar
  37. 37.
    De Lignieres B, Vincens M, Mauvais-Jarvis P et al. (1986) Prevention of menstrual migraine by percutaneous oestradiol. Br Med J (Clin Res Ed) 293(6561): 1540Google Scholar
  38. 38.
    Dennerstein L, Morse C, Burrows G et al. (1988) Menstrual migraine: a double-blind trial of percutaneous estradiol. Gynecol Endocrinol 2: 113–120PubMedCrossRefGoogle Scholar
  39. 39.
    MacGregor EA, Frith A, Ellis J et al. (2006) Prevention of menstrual attacks of migraine: a double-blind placebo-controlled crossover study. Neurology 67: 2159–2163PubMedCrossRefGoogle Scholar
  40. 40.
    Edelman A, Gallo MF, Nichols MD et al. (2006) Continuous versus cyclic use of combined oral contraceptives for contraception: systematic Cochrane review of randomized controlled trials. Hum Reprod 21: 573–578PubMedCrossRefGoogle Scholar
  41. 41.
    MacGregor A (2007) Menstrual migraine: a clinical review. J Fam Plann Reprod Health Care 33: 36–47PubMedCrossRefGoogle Scholar
  42. 42.
    Silberstein SD (2001) Headache and female hormones: what you need to know. Curr Opin Neurol 14: 323–333PubMedCrossRefGoogle Scholar
  43. 43.
    Solbach P, Sargent J, Coyne L (1984) Menstrual migraine headache: results of a controlled, experimental, outcome study of non-drug treatments. Headache 24: 75–78PubMedCrossRefGoogle Scholar
  44. 44.
    Linde M, Fjell A, Carlsson J, Dahlof C (2005) Role of the needling per se in acupuncture as prophylaxis for menstrually related migraine: a randomized placebo-controlled study. Cephalalgia 25: 41–47PubMedCrossRefGoogle Scholar
  45. 45.
    Szekely B, Botwin D, Eidelman BH et al. (1986) Nonpharmacological treatment of menstrual headache: relaxation-biofeedback behavior therapy and person-centered insight therapy. Headache 26: 86–92PubMedCrossRefGoogle Scholar
  46. 46.
    Sances G, Granella F, Nappi RE et al. (2003) Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia 23: 197–205PubMedCrossRefGoogle Scholar
  47. 47.
    Maggioni F, Alessi C, Maggino T, Zanchin G (1997) Headache during pregnancy. Cephalalgia 17: 765–769PubMedCrossRefGoogle Scholar
  48. 48.
    Chen TC, Leviton A (1994) Headache recurrence in pregnant women with migraine. Headache 34: 107–110PubMedCrossRefGoogle Scholar
  49. 49.
    Ertresvag JM, Zwart JA, Helde G et al. (2005) Headache and transient focal neurological symptoms during pregnancy, a prospective cohort. Acta Neurol Scand 111: 233–237PubMedCrossRefGoogle Scholar
  50. 50.
    Melhado E, Maciel JA jr, Guerreiro CA (2005) Headaches during pregnancy in women with a prior history of menstrual headaches. Arq Neuropsiquiatr 63: 934–940PubMedGoogle Scholar
  51. 51.
    Marcus DA, Scharff L, Turk D (1999) Longitudinal prospective study of headache during pregnancy and postpartum. Headache 39: 625–632PubMedCrossRefGoogle Scholar
  52. 52.
    Cupini LM, Matteis M, Troisi E et al. (1995) Sex-hormone-related events in migrainous females. A clinical comparative study between migraine with aura and migraine without aura. Cephalalgia 15: 140–144PubMedCrossRefGoogle Scholar
  53. 53.
    Mandel S (1988) Hemiplegic migraine in pregnancy. Headache 28: 414–416PubMedCrossRefGoogle Scholar
  54. 54.
    Stein G, Morton J, Marsh A et al. (1984) Headaches after childbirth. Acta Neurol Scand 69: 74–79PubMedGoogle Scholar
  55. 55.
    Scharff L, Marcus DA, Turk DC (1997) Headache during pregnancy and in the postpartum: a prospective study. Headache 37: 203–210PubMedCrossRefGoogle Scholar
  56. 56.
    James AH, Bushnell CD, Jamison MG, Myers ER (2005) Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol 106: 509–516PubMedGoogle Scholar
  57. 57.
    Campbell OM, Gray RH (1993) Characteristics and determinants of postpartum ovarian function in women in the United States. Am J Obstet Gynecol 169: 55–60PubMedGoogle Scholar
  58. 58.
    Wang SJ, Fuh JL, Lu SR et al. (2003) Migraine prevalence during menopausal transition. Headache 43: 470–478PubMedCrossRefGoogle Scholar
  59. 59.
    Neri I, Granella F, Nappi R et al. (1993) Characteristics of headache at menopause: a clinico-epidemiologic study. Maturitas 17: 31–37PubMedCrossRefGoogle Scholar
  60. 60.
    Oldenhave A, Jaszmann LJ, Everaerd WT, Haspels AA (1993) Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal climacteric women of similar age. Am J Obstet Gynecol 168(3 Pt 1): 765–771PubMedGoogle Scholar
  61. 61.
    MacGregor EA, Barnes D (1999) Migraine in a specialist menopause clinic. Climacteric 2: 218–223PubMedCrossRefGoogle Scholar
  62. 62.
    Hodson J, Thompson J, al-Azzawi F (2000) Headache at menopause and in hormone replacement therapy users. Climacteric 3: 119–124PubMedCrossRefGoogle Scholar
  63. 63.
    Misakian AL, Langer RD, Bensenor IM et al. (2003) Postmenopausal hormone therapy and migraine headache. J Womens Health (Larchmt) 12: 1027–1036CrossRefGoogle Scholar
  64. 64.
    Lichten EM, Lichten JB, Whitty A, Pieper D et al. (1996) The confirmation of a biochemical marker for women’s hormonal migraine: the depo-estradiol challenge test. Headache 36: 367–371PubMedCrossRefGoogle Scholar
  65. 65.
    Facchinetti F, Nappi RE, Tirelli A et al. (2002) Hormone supplementation differently affects migraine in postmenopausal women. Headache 42: 924–929PubMedCrossRefGoogle Scholar
  66. 66.
    Kudrow L (1975) The relationship of headache frequency to hormone use in migraine. Headache 15: 36–40PubMedCrossRefGoogle Scholar
  67. 67.
    Evans MP, Fleming KC, Evans JM (1995) Hormone replacement therapy: management of common problems. Mayo Clin Proc 70: 800–805PubMedCrossRefGoogle Scholar
  68. 68.
    MacGregor A (1999) Effects of oral and transdermal estrogen replacement on migraine. Cephalalgia 19: 124–125PubMedCrossRefGoogle Scholar
  69. 69.
    Nappi RE, Cagnacci A, Granella F et al. (2001) Course of primary headaches during hormone replacement therapy. Maturitas 38: 157–163PubMedCrossRefGoogle Scholar
  70. 70.
    Kaiser HJ, Meienberg O (1993) Deterioration or onset of migraine under oestrogen replacement therapy in the menopause. J Neurol 240: 195–196PubMedCrossRefGoogle Scholar
  71. 71.
    MacGregor A (1999) Estrogen replacement and migraine aura. Headache 39: 674–678PubMedCrossRefGoogle Scholar
  72. 72.
    Kurth T, Slomke MA, Kase CS et al. (2005) Migraine, headache, and the risk of stroke in women: a prospective study. Neurology 64: 1020–1026PubMedGoogle Scholar
  73. 73.
    MacGregor EA (2006) Migraine and the menopause. J Br Menopause Soc 12: 104–108PubMedCrossRefGoogle Scholar
  74. 74.
    Martin VT, Behbehani M (2006) Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis – part I. Headache 46: 3–23PubMedCrossRefGoogle Scholar
  75. 75.
    Chen Z, Yuhanna IS, Galcheva-Gargova Z et al. (1999) Estrogen receptor alpha mediates the nongenomic activation of endothelial nitric oxide synthase by estrogen. J Clin Invest 103: 401–406PubMedCrossRefGoogle Scholar
  76. 76.
    Puri V, Puri S, Svojanovsky SR et al. (2006) Effects of oestrogen on trigeminal ganglia in culture: implications for hormonal effects on migraine. Cephalalgia 26: 33–42PubMedCrossRefGoogle Scholar
  77. 77.
    Puri V, Cui L, Liverman CS et al. (2005) Ovarian steroids regulate neuropeptides in the trigeminal ganglion. Neuropeptides 39: 409–417PubMedCrossRefGoogle Scholar
  78. 78.
    Smith LJ, Henderson JA, Abell CW, Bethea CL (2004) Effects of ovarian steroids and raloxifene on proteins that synthesize, transport, and degrade serotonin in the raphe region of macaques. Neuropsychopharmacology 29: 2035–2045PubMedCrossRefGoogle Scholar
  79. 79.
    Jarrett RJ, Graver HJ (1968) Changes in oral glucose tolerance during the menstrual cycle. Br Med J 2(5604): 528–529PubMedGoogle Scholar
  80. 80.
    Bertoli A, De Pirro R, Fusco A et al. (1980) Differences in insulin receptors between men and menstruating women and influence of sex hormones on insulin binding during the menstrual cycle. J Clin Endocrinol Metab 50: 246–250PubMedCrossRefGoogle Scholar
  81. 81.
    Horrobin DF (1977) Hypothesis: prostaglandins and migraine. Headache 17: 113–117PubMedCrossRefGoogle Scholar
  82. 82.
    Carlson LA, Ekelund LG, Oro L (1968) Clinical and metabolic effects of different doses of prostaglandin E1 in man. Prostaglandin and related factors. Acta Med Scand 183: 423–430PubMedCrossRefGoogle Scholar
  83. 83.
    Koshikawa N, Tatsunuma T, Furuya K, Seki K (1992) Prostaglandins and premenstrual syndrome. Prostaglandins Leukot Essent Fatty Acids 45: 33–36PubMedCrossRefGoogle Scholar
  84. 84.
    Colson NJ, Lea RA, Quinlan S et al. (2004) The estrogen receptor 1 G594A polymorphism is associated with migraine susceptibility in two independent case/control groups. Neurogenetics 5: 129–133PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Klinik und Poliklinik für NeurologieUniversitäts-Klinkum Hamburg Eppendorf (UKE)HamburgDeutschland

Personalised recommendations