Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients

Li, Wei; Diao, Xiaojun; Chen, Chun-Fu; Li, Congcong; Zhang, Yingbo; Li, Yingying

doi:10.1016/j.jocn.2017.11.011

Cited by 23 publications

(31 citation statements)

References 28 publications

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“…17,18 It is unclear why older patients are more refractory to treatment than younger patients, but considering that after puberty the incidence of migraine becomes significantly higher in females 19,20 and considering that we also found that females were more likely to worsen than males, it could be due to a hormonal effect. Fluctuations in hormone levels throughout the menstrual cycle are associated with headache parameters in females with migraine [21][22][23] and recent pilot data in girls suggest that the stage of pubertal development may impact the effect of sex steroids on headache parameters. 22 Therefore, part of the age effect observed in the present study could be mediated by the hormonal changes that occur with puberty.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

et al. 2019

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Objectives To characterize the short‐term prognosis of a clinical population of pediatric and young adult patients with migraine and explore predictors of clinical worsening while in care. Methods This was a retrospective study of all migraine patients seen at the Cincinnati Children’s Hospital Headache Center from 09/01/2006 to 12/31/2017, who had at least 1 follow‐up visit within 1‐3 months of the index visit analyzed. Included data were: age, sex, race, primary ICHD diagnosis, chronic migraine, medication overuse, history of status migrainosus, BMI percentile, headache frequency, headache severity, PedMIDAS score, allodynia, preventive treatment type, lifestyle habits, disease duration, depressive and anxiety symptoms. Clinical worsening was defined as an increase in 4 or more headache days per month between the index visit and the follow‐up visit. Results Data for 13,160 visit pairs (index and follow‐up), from 5316 patients, were analyzed. Clinical worsening occurred in only 14.5% (1908/13,160), whereas a reduction in headache frequency was observed in 56.8% of visit intervals (7475/13,160), with 34.8% of the intervals (4580/13,160) showing a reduction of 50% or greater. The change in headache frequency was minimal (increase in 0‐3 headaches/month) in 28.7% of intervals (3737/13,160). In the multivariable model, the odds of worsening were significantly higher with increasing age, female sex, chronic migraine, status migrainosus, depressive symptoms, higher PedMIDAS scores, and use of nutraceuticals, whereas the odds of worsening were lower for summer visits, caffeine drinkers, higher headache frequencies, and use of pharmaceuticals. Conclusions The majority of pediatric patients who receive multimodal interdisciplinary care for migraine improve over time. Our findings highlight a set of clinical features that may help in identifying specific factors that may contribute to an unfavorable short‐term prognosis.

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Section: Discussionmentioning

confidence: 99%

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

et al. 2019

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“…Abnormality of the hypothalamuspituitary- gonadal axis is believed to be involved in the pathogenesis of migraine. 15 In Li and colleagues’ study of the levels of HPG axis hormones serum FSH, LH, estradiol, progesterone, testosterone, prolactin, and GnRH, they reported that these hormones were abnormal in migraineurs and were associated with migraine-related clinical characteristics. 15…”

Section: Discussionmentioning

confidence: 99%

Testosterone levels in men with chronic migraine

et al. 2019

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Chronic migraine is a frequent and debilitating condition affecting 14% of the general population. This prospective observational pilot study investigated whether men with chronic migraine have lower than expected total serum testosterone levels. We identified 14 men ages 26-51 at our Institution who fulfilled the ICHD-3b criteria for chronic migraine and obtained serum total testosterone levels. The mean total testosterone level in our 14 patients was 322 ng/dL (range: 120-542 ng/dL) which is in the lower 5% of the reference range for our laboratory (300-1080 ng/dL). Men with chronic migraine had lower total testosterone levels compared to published agematched normative median values by a median difference of 62 ng/dL (P=0.0494). This finding suggests that hypothalamic regulation is altered in patients with chronic migraine. Further studies are warranted to determine whether testosterone supplementation in men with chronic migraine reduces the number of headaches or the associated symptoms of hypogonadism.

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“…They found that levels of progesterone in males and females with migraine in the postmenopausal phase were lower compared to healthy controls. Also, they found significantly higher levels of gonadotropin-releasing hormone (GNRH) in males with migraine, in the follicular phase as well as the luteal phase in females with migraine, and in postmenopausal females with migraine compared to controls (68).…”

Section: Sex Hormonesmentioning

confidence: 99%

Giving Researchers a Headache – Sex and Gender Differences in Migraine

et al. 2020

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Migraine is a common neurovascular disorder affecting ∼15% of the general population. Ranking second in the list of years lived with disability (YLD), people living with migraine are greatly impacted by this especially burdensome primary headache disorder. In ∼30% of individuals with migraine, transient neurological symptoms occur (migraine aura) that further increase migraine burden. However, migraine burden is differential with respect to sex. Though one-year prevalences in childhood are similar, starting with puberty, migraine incidence increases at a much higher rate in females than males. Thus, migraine over the life course occurs in women three to four times more often than in men. Attacks are also more severe in women, leading to greater disability and a longer recovery period. The sex disparity in migraine is believed to be partly mediated through fluctuations in ovarian steroid hormones, especially estrogen and progesterone, although the exact mechanisms are not yet completely understood. The release of the neuropeptide calcitonin gene-related peptide (CGRP), followed by activation of the trigeminovascular system, is thought to play a key role in the migraine pathophysiology. Given the burden of migraine and its disproportionate distribution, the underlying cause(s) for the observed differences between sexes in the incidence, frequency, and intensity of migraine attacks must be better understood. Relevant biological as well as behavioral differences must be taken into account. To evaluate the scope of the existing knowledge on the issue of biological sex as well as gender differences in migraine, we conducted a systematized review of the currently available research. The review seeks to harmonize existing knowledge on the topic across the domains of biological/preclinical, clinical, and population-level research, which are traditionally synthesized and interpreted in isolation. Ultimately, we identify knowledge gaps and set priorities for further interdisciplinary and informed research on sex and gender differences as well as gender-specific therapies in migraine.

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Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients

Cited by 23 publications

References 28 publications

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

Testosterone levels in men with chronic migraine

Giving Researchers a Headache – Sex and Gender Differences in Migraine

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