Sex hormones in women with and without migraine

Jelena M. Pavlovic, Amanda A. Allshouse, Nanette F. Santoro, Sybil L. Crawford, Rebecca C. Thurston, Genevieve S. Neal-Perry, Richard B. Lipton, Carol A. Derby

Research output: Contribution to journalArticle

36 Scopus citations


Objective: To compare daily sex hormone levels and rates of change between women with history of migraine and controls. Methods: History of migraine, daily headache diaries, and daily hormone data were collected in ovulatory cycles of pre- and early perimenopausal women in the Study of Women's Health Across the Nation. Peak hormone levels, average daily levels, and within-woman day-to-day rates of decline over the 5 days following each hormone peak were calculated in ovulatory cycles for conjugated urinary estrogens (E1c), pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone. Comparisons were made between migraineurs and controls using 2-sample t tests on the log scale with results reported as geometric means. Results: The sample included 114 women with history of migraine and 223 controls. Analyses of within-woman rates of decline showed that E1c decline over the 2 days following the luteal peak was greater in migraineurs for both absolute rate of decline (33.8 [95% confidence interval 28.0-40.8] pg/mgCr vs 23.1 [95% confidence interval 20.1-26.6] pg/mgCr, p 0.002) and percent change (40% vs 30%, p <0.001). There was no significant difference between migraineurs and controls in absolute peak or daily E1c, pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone levels. Secondary analyses demonstrated that, among migraineurs, the rate of E1c decline did not differ according to whether a headache occurred during the cycle studied. Conclusions: Migraineurs are characterized by faster late luteal phase E1c decline compared to controls. The timing and rate of estrogen withdrawal before menses may be a marker of neuroendocrine vulnerability in women with migraine.

Original languageEnglish (US)
Pages (from-to)49-56
Number of pages8
Issue number1
StatePublished - Jul 5 2016

ASJC Scopus subject areas

  • Clinical Neurology

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    Pavlovic, J. M., Allshouse, A. A., Santoro, N. F., Crawford, S. L., Thurston, R. C., Neal-Perry, G. S., Lipton, R. B., & Derby, C. A. (2016). Sex hormones in women with and without migraine. Neurology, 87(1), 49-56.