Neurológia pre prax 6/2014

Migraine in women

Migraine is a predominantly female disorder. Menarche, menstruation, pregnancy, and menopause, and also the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. Migraine usually starts after menarche, occurs more frequently in the days just before or during menstruation, and ameliorates during pregnancy and menopause. Those variations are mediated by fluctuation of estrogen levels through their influence on cellular excitability. Moreover, administration of exogenous hormones may cause worsening of migraine and may expose migrainous women to an increased risk of vascular disease. Migraine with aura represents a risk factor for stroke. Administration of combined oral contraceptives to migraineurs may further increase the risk for ischemic stroke.

Keywords: migraine, estrogens, menstrual migraine, pregnancy, menopause, hormonal contraception.