Longitudinal course of vasomotor symptoms in perimenopausal migraineurs

Abstract

Objective: To examine the longitudinal course of vasomotor symptoms (VMS) in women with a history of migraine in comparison to women without a history of migraine disease. Methods: The study sample consisted of 467 women with a self-reported prior migraine diagnosis and 2,466 women without prior migraine diagnosis who were assessed longitudinally during menopausal transition as part of the Study of Women's Health Across the Nation. Linear mixed regression models with backward elimination were used to evaluate longitudinal associations between VMS and migraine while adjusting for baseline and time-varying demographic, socioeconomic, psychological, and reproductive factors. Additional analyses were performed to further assess the specificity of the association between migraine and VMS that included evaluating the association between migraine and vaginal dryness and between back pain and VMS. Results: A history of migraine predicted an increased frequency of VMS but not vaginal dryness during menopausal transition. Significant interaction between history of migraine and menopausal status for the prediction of VMS was also identified. Burden of VMS was found to be higher during late-stage perimenopause in women with migraine. In contrast, the history of back pain did not predict the frequency of VMS. Interpretation: This is the first study to delineate that a history of migraine predicts an increased frequency of VMS in women during menopausal transition. Hypothalamic abnormalities and thermoregulatory dysfunction against a milieu of decreasing estradiol concentrations during menopausal transition may explain the increased frequency of VMS in migraineurs during menopausal transition.

The impact of midlife on migraine in women: summary of current views

“…A recent study using the SWAN cohort evaluated the presence of vasomotor symptoms in women with migraine over up to 10 years of follow-up [53]. This study found that a history of migraine predicted higher frequency of hot flashes and night sweats [53]. Overall, these studies support the notion that the prevalence and burden of migraine are most pronounced in perimenopause when hormonal imbalance is present, particularly in women with history of menstrual migraine.…”

“…Further, in cross-sectional studies, vasomotor symptoms have been reported to be more common among women with migraine [46]. A recent study using the SWAN cohort evaluated the presence of vasomotor symptoms in women with migraine over up to 10 years of follow-up [53]. This study found that a history of migraine predicted higher frequency of hot flashes and night sweats [53].…”

Allostatic Load in Perimenopausal Women With Migraine

“…Migraineurs were identified per self-report similar to previous reported studies in this population (12,19). Participants were asked if a doctor or any other health professional had diagnosed them with migraine headaches.…”

“…In this study we hypothesized that women with migraine experience a significantly higher allostatic profile due to the added burden of frequent headaches and increased sleep disturbances during menopausal transition. This hypothesis is based on the burden of repeated migraine attacks as stressors (10, 11), the central role of the hypothalamically-mediated homeostasis (12) to the pathophysiology of migraine, and the significant modulatory influence of hormonal fluctuations during menopausal transition on the brain (13). Furthermore, since sleep disturbances have long been associated with migraines and other headache disorders (14), and sleep disorders are one of the main symptoms associated with menopausal transition (15)(16)(17), we hypothesized that sleep problems will have a modulatory influence on allostatic load and exacerbate it.…”

Is There Any MRI Pattern That Discriminates Female From Male Migraine Patients?

“…Fluctuations and decline in the levels of ovarian hormones during this period also have significant modulatory influences on brain function (52–55), which could have significant implications for neurological disorders, including migraine (56, 57). A recent study provides evidence for increased incidence of vasomotor symptoms in aging women with a history of migraine (58). This finding may be concordant with neuroimaging findings that have shown sex-specific and disease specific abnormalities in the structure and function of the insular cortex, the core cortical region for autonomic integration, in women with migraine.…”