Association between sex hormones and migraine in young Saudi females

Abstract

Objectives: To assess the sex hormone levels in young Saudi female migraineurs during a migraine attack and during pain-free periods and compare them with control subjects. Methods:A case-control study involving 14 Saudi female migraineurs and 21 control subjects was conducted between December 2019 and March 2020. Demographic and disease history data were collected through participant interviews. Blood samples were drawn during the migraine attack and pain-free periods.Results: Follicular (30.00±19.60; p<0.001) and luteal (39.79±11.45; p=0.037) estrogen levels were significantly higher in patients with non-menstrual related migraine (NMM), while luteal testosterone levels (1.10±0.31; p=0.023) were significantly higher in patients with menstrually related migraine (MM). Body mass index (BMI) was higher in patients with NMM (25.77±6.53; p=0.013), and it was found to be associated with follicular estrogen (p=0.016), progesterone (p=0.018), and pain intensity (p=0.042). Luteal estrogen level was significantly lower (13.96±7.88; p=0.036) in patients with luteal onset of attack. Conclusion:High estrogen levels were found to mediate NMM, their effect being more pronounced with increase in BMI; whereas low luteal estrogen levels mediated MM. Young females with MM might have high luteal testosterone levels, and a compensatory protective role could be surmised accordingly.

Sex and stress hormone dysregulation as clinical manifestations of hypothalamic function in migraine disorder: A meta‐analysis

“…One study (Shields et al, 2019) was included though it displayed high risk as it compared migraineurs to laboratory norms rather than healthy controls (Shields et al, 2019); inclusion was justified based on the consideration of laboratory norms to be equivalent to a healthy control population. Another study was excluded based on the risk of bias (Al Asoom et al, 2021) due to insufficient power, ictal measurement of estrogen and progesterone (whereas all other estrogen/progesterone studies measured interictally [Nagel‐Leiby et al, 1990; de Lourdes Figuerola et al, 1997; Kibler et al, 2005; Yucel et al, 2005; Ibrahimi et al, 2015; Li et al, 2018]), and significantly different body mass index between control and non‐menstrually related migraine groups. As body mass index has previously been reported to be positively correlated with estrogen levels, this potentially confounded results (Siiteri, 1987).…”

Sexual dysfunction in migraine-affected women: A prospective cross-sectional controlled study

“…Globally, the proportion of adults with headaches is 65 %; 42 % for tension-type headache, 20 % for migraine, and 3 % for chronic headaches [11] . In Saudi Arabia, the incidence of migraine, in general, is 26.97 %, with women having three times the frequency of men [12] .…”

“…One study indicated prevalence of migraine among women is 18.2 %, and only 6.5 % among men. Some hypothesized the role of sex hormones (mainly Oestrogen) in the pathophysiology of migraine which could explain its higher prevalence among females [12] .…”

Whole-Exome Sequencing Reveals Migraine-Associated Novel Functional Variants in Arab Ancestry Females: A Pilot Study

“…Hemiplegic migraine is another type of MA and is a severe and rare condition that affects one side of the body and causes temporary numbness [ 9 ]. It once was believed that migraine is a vascular disease; however, many recent types of research confirmed the involvement of multiple mechanisms related to the brain structures and processes [ 10 ]. Furthermore, accumulated evidence demonstrates a genetic background for the transmission of the disease.…”