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Migräne und Hormone: Was ist gesichert?

Migraine and hormones: what can we be certain of?

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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.

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.

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Literatur

  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: 185–193

    Article  PubMed  CAS  Google Scholar 

  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: 302–308

    Article  PubMed  CAS  Google Scholar 

  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: 385–389

    Article  PubMed  CAS  Google Scholar 

  4. MacGregor EA, Chia H, Vohrah RC, Wilkinson M (1990) Migraine and menstruation: a pilot study. Cephalalgia 10: 305–310

    Article  PubMed  CAS  Google Scholar 

  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: 1076–1082

    PubMed  CAS  Google Scholar 

  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: 2154–2158

    Article  PubMed  CAS  Google Scholar 

  7. Stewart WF, Lipton RB, Chee E et al. (2000) Menstrual cycle and headache in a population sample of migraineurs. Neurology 55: 1517–1523

    PubMed  CAS  Google Scholar 

  8. Rasmussen BK, Olesen J (1992) Migraine with aura and migraine without aura: an epidemiological study. Cephalalgia 12: 221–228; discussion 186

    Article  PubMed  CAS  Google Scholar 

  9. Granella F, Sances G, Pucci E et al. (2000) Migraine with aura and reproductive life events: a case control study. Cephalalgia 20: 701–707

    Article  PubMed  CAS  Google Scholar 

  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: 707–716

    Article  PubMed  CAS  Google Scholar 

  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: 274–282

    Article  PubMed  Google Scholar 

  12. MacGregor EA, Hackshaw A (2004) Prevalence of migraine on each day of the natural menstrual cycle. Neurology 63: 351–353

    PubMed  Google Scholar 

  13. Somerville BW (1971) The role of progesterone in menstrual migraine. Neurology 21: 853–859

    PubMed  CAS  Google Scholar 

  14. Somerville BW (1972) The role of estradiol withdrawal in the etiology of menstrual migraine. Neurology 22: 355–365

    PubMed  CAS  Google Scholar 

  15. Somerville BW (1975) Estrogen-withdrawal migraine. II. Attempted prophylaxis by continuous estradiol administration. Neurology 25: 245–250

    PubMed  CAS  Google Scholar 

  16. Somerville BW (1975) Estrogen-withdrawal migraine. I. Duration of exposure required and attempted prophylaxis by premenstrual estrogen administration. Neurology 25: 239–244

    PubMed  CAS  Google Scholar 

  17. Nagel-Leiby S, Welch KM, Grunfeld S, D’Andrea G (1990) Ovarian steroid levels in migraine with and without aura. Cephalalgia 10: 147–152

    Article  PubMed  CAS  Google Scholar 

  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: 911–916

    Article  PubMed  CAS  Google Scholar 

  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: 120–130

    Article  PubMed  Google Scholar 

  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: 414–421

    Article  PubMed  CAS  Google Scholar 

  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–S197

    Google Scholar 

  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: 774–781

    Article  PubMed  CAS  Google Scholar 

  23. Brandes JL, Kudrow D, Stark SR et al. (2007) Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA 297: 1443–1454

    Article  PubMed  CAS  Google Scholar 

  24. Benedetto C (1989) Eicosanoids in primary dysmenorrhea, endometriosis and menstrual migraine. Gynecol Endocrinol 3: 71–94

    Article  PubMed  CAS  Google Scholar 

  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–S228

    Google Scholar 

  26. Sances G, Martignoni E, Fioroni L et al. (1990) Naproxen sodium in menstrual migraine prophylaxis: a double-blind placebo controlled study. Headache 30: 705–709

    Article  PubMed  CAS  Google Scholar 

  27. Szekely BC (1991) Naproxen for perimenstrual headache. Headache 31: 345

    Article  PubMed  CAS  Google Scholar 

  28. Von Seggern RL, Mannix LK, Adelman JU (2004) Rofecoxib in the prevention of perimenstrual migraine: an open-label pilot trial. Headache 44: 160–165

    Article  Google Scholar 

  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–s166

    Google Scholar 

  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: 248–256

    Article  PubMed  CAS  Google Scholar 

  31. Silberstein SD, Elkind AH, Schreiber C, Keywood C (2004) A randomized trial of frovatriptan for the intermittent prevention of menstrual migraine. Neurology 63: 261–269

    PubMed  CAS  Google Scholar 

  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: 307–309

    PubMed  CAS  Google Scholar 

  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: 1037–1049

    Article  PubMed  Google Scholar 

  34. Pfaffenrath V (1993) Efficacy and safetey of percutaeous estradiol vs. placebo in menstrual migraine. Cephalalgia 13 [suppl]: 244

    Google Scholar 

  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: 103–106

    Article  PubMed  CAS  Google Scholar 

  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: 27–31

    Article  PubMed  Google Scholar 

  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): 1540

    Google Scholar 

  38. Dennerstein L, Morse C, Burrows G et al. (1988) Menstrual migraine: a double-blind trial of percutaneous estradiol. Gynecol Endocrinol 2: 113–120

    Article  PubMed  CAS  Google Scholar 

  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: 2159–2163

    Article  PubMed  CAS  Google Scholar 

  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: 573–578

    Article  PubMed  CAS  Google Scholar 

  41. MacGregor A (2007) Menstrual migraine: a clinical review. J Fam Plann Reprod Health Care 33: 36–47

    Article  PubMed  Google Scholar 

  42. Silberstein SD (2001) Headache and female hormones: what you need to know. Curr Opin Neurol 14: 323–333

    Article  PubMed  CAS  Google Scholar 

  43. Solbach P, Sargent J, Coyne L (1984) Menstrual migraine headache: results of a controlled, experimental, outcome study of non-drug treatments. Headache 24: 75–78

    Article  PubMed  CAS  Google Scholar 

  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: 41–47

    Article  PubMed  CAS  Google Scholar 

  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: 86–92

    Article  PubMed  CAS  Google Scholar 

  46. Sances G, Granella F, Nappi RE et al. (2003) Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia 23: 197–205

    Article  PubMed  CAS  Google Scholar 

  47. Maggioni F, Alessi C, Maggino T, Zanchin G (1997) Headache during pregnancy. Cephalalgia 17: 765–769

    Article  PubMed  CAS  Google Scholar 

  48. Chen TC, Leviton A (1994) Headache recurrence in pregnant women with migraine. Headache 34: 107–110

    Article  PubMed  CAS  Google Scholar 

  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: 233–237

    Article  PubMed  CAS  Google Scholar 

  50. Melhado E, Maciel JA jr, Guerreiro CA (2005) Headaches during pregnancy in women with a prior history of menstrual headaches. Arq Neuropsiquiatr 63: 934–940

    PubMed  Google Scholar 

  51. Marcus DA, Scharff L, Turk D (1999) Longitudinal prospective study of headache during pregnancy and postpartum. Headache 39: 625–632

    Article  PubMed  CAS  Google Scholar 

  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: 140–144

    Article  PubMed  CAS  Google Scholar 

  53. Mandel S (1988) Hemiplegic migraine in pregnancy. Headache 28: 414–416

    Article  PubMed  CAS  Google Scholar 

  54. Stein G, Morton J, Marsh A et al. (1984) Headaches after childbirth. Acta Neurol Scand 69: 74–79

    PubMed  CAS  Google Scholar 

  55. Scharff L, Marcus DA, Turk DC (1997) Headache during pregnancy and in the postpartum: a prospective study. Headache 37: 203–210

    Article  PubMed  CAS  Google Scholar 

  56. James AH, Bushnell CD, Jamison MG, Myers ER (2005) Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol 106: 509–516

    PubMed  Google Scholar 

  57. Campbell OM, Gray RH (1993) Characteristics and determinants of postpartum ovarian function in women in the United States. Am J Obstet Gynecol 169: 55–60

    PubMed  CAS  Google Scholar 

  58. Wang SJ, Fuh JL, Lu SR et al. (2003) Migraine prevalence during menopausal transition. Headache 43: 470–478

    Article  PubMed  Google Scholar 

  59. Neri I, Granella F, Nappi R et al. (1993) Characteristics of headache at menopause: a clinico-epidemiologic study. Maturitas 17: 31–37

    Article  PubMed  CAS  Google Scholar 

  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): 765–771

    PubMed  CAS  Google Scholar 

  61. MacGregor EA, Barnes D (1999) Migraine in a specialist menopause clinic. Climacteric 2: 218–223

    Article  PubMed  CAS  Google Scholar 

  62. Hodson J, Thompson J, al-Azzawi F (2000) Headache at menopause and in hormone replacement therapy users. Climacteric 3: 119–124

    Article  PubMed  CAS  Google Scholar 

  63. Misakian AL, Langer RD, Bensenor IM et al. (2003) Postmenopausal hormone therapy and migraine headache. J Womens Health (Larchmt) 12: 1027–1036

    Article  Google Scholar 

  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: 367–371

    Article  PubMed  CAS  Google Scholar 

  65. Facchinetti F, Nappi RE, Tirelli A et al. (2002) Hormone supplementation differently affects migraine in postmenopausal women. Headache 42: 924–929

    Article  PubMed  CAS  Google Scholar 

  66. Kudrow L (1975) The relationship of headache frequency to hormone use in migraine. Headache 15: 36–40

    Article  PubMed  CAS  Google Scholar 

  67. Evans MP, Fleming KC, Evans JM (1995) Hormone replacement therapy: management of common problems. Mayo Clin Proc 70: 800–805

    Article  PubMed  CAS  Google Scholar 

  68. MacGregor A (1999) Effects of oral and transdermal estrogen replacement on migraine. Cephalalgia 19: 124–125

    Article  PubMed  CAS  Google Scholar 

  69. Nappi RE, Cagnacci A, Granella F et al. (2001) Course of primary headaches during hormone replacement therapy. Maturitas 38: 157–163

    Article  PubMed  CAS  Google Scholar 

  70. Kaiser HJ, Meienberg O (1993) Deterioration or onset of migraine under oestrogen replacement therapy in the menopause. J Neurol 240: 195–196

    Article  PubMed  CAS  Google Scholar 

  71. MacGregor A (1999) Estrogen replacement and migraine aura. Headache 39: 674–678

    Article  PubMed  CAS  Google Scholar 

  72. Kurth T, Slomke MA, Kase CS et al. (2005) Migraine, headache, and the risk of stroke in women: a prospective study. Neurology 64: 1020–1026

    PubMed  CAS  Google Scholar 

  73. MacGregor EA (2006) Migraine and the menopause. J Br Menopause Soc 12: 104–108

    Article  PubMed  Google Scholar 

  74. Martin VT, Behbehani M (2006) Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis – part I. Headache 46: 3–23

    Article  PubMed  Google Scholar 

  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: 401–406

    Article  PubMed  CAS  Google Scholar 

  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: 33–42

    Article  PubMed  CAS  Google Scholar 

  77. Puri V, Cui L, Liverman CS et al. (2005) Ovarian steroids regulate neuropeptides in the trigeminal ganglion. Neuropeptides 39: 409–417

    Article  PubMed  CAS  Google Scholar 

  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: 2035–2045

    Article  PubMed  CAS  Google Scholar 

  79. Jarrett RJ, Graver HJ (1968) Changes in oral glucose tolerance during the menstrual cycle. Br Med J 2(5604): 528–529

    PubMed  CAS  Google Scholar 

  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: 246–250

    Article  PubMed  CAS  Google Scholar 

  81. Horrobin DF (1977) Hypothesis: prostaglandins and migraine. Headache 17: 113–117

    Article  PubMed  CAS  Google Scholar 

  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: 423–430

    Article  PubMed  CAS  Google Scholar 

  83. Koshikawa N, Tatsunuma T, Furuya K, Seki K (1992) Prostaglandins and premenstrual syndrome. Prostaglandins Leukot Essent Fatty Acids 45: 33–36

    Article  PubMed  CAS  Google Scholar 

  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: 129–133

    Article  PubMed  CAS  Google Scholar 

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  1. Klinik und Poliklinik für Neurologie, Universitäts-Klinkum Hamburg Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland

    U. Bingel

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Bingel, U. Migräne und Hormone: Was ist gesichert?. Schmerz 22 (Suppl 1), 31–36 (2008). https://doi.org/10.1007/s00482-007-0613-9

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