Leiden University Scholarly Publications

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Verhagen, I.E.; Arend, B.W.H. van der; Casteren, D.S. van; Thiermann, N.J.S.; Tange, E.; MaassenVanDenBrink, A.; Terwindt, G.M. (2023)

Migraine with and without aura in relation to the menstrual cycle and other hormonal milestones: a prospective cohort study

Article / Letter to editor
BackgroundPrevious studies showed that the perimenstrual window is associated with an increased susceptibility to migraine attacks without aura, but had conflicting results regarding attacks with aura.MethodsWe performed a longitudinal E-diary study among 526 premenopausal women with migraine. Differences in occurrence of perimenstrual migraine attacks between women with migraine with aura and without aura were assessed using a mixed effects logistic regression model. Additionally, participants completed a questionnaire about the influence of hormonal milestones on migraine frequency.ResultsPrevalence of menstrual migraine did not differ between women with migraine without aura and migraine with aura (59% versus 53%, p = 0.176). The increased risk of migraine attacks without aura during the perimenstrual window was similar for women with migraine without aura (OR[95%CI]:1.53 [1.44-1.62]) and those with migraine with aura (1.53 [1.44-1.62]). The perimenstrual window was not...Show moreBackgroundPrevious studies showed that the perimenstrual window is associated with an increased susceptibility to migraine attacks without aura, but had conflicting results regarding attacks with aura.MethodsWe performed a longitudinal E-diary study among 526 premenopausal women with migraine. Differences in occurrence of perimenstrual migraine attacks between women with migraine with aura and without aura were assessed using a mixed effects logistic regression model. Additionally, participants completed a questionnaire about the influence of hormonal milestones on migraine frequency.ResultsPrevalence of menstrual migraine did not differ between women with migraine without aura and migraine with aura (59% versus 53%, p = 0.176). The increased risk of migraine attacks without aura during the perimenstrual window was similar for women with migraine without aura (OR[95%CI]:1.53 [1.44-1.62]) and those with migraine with aura (1.53 [1.44-1.62]). The perimenstrual window was not associated with increased risk of migraine aura attacks (1.08 [0.93-1.26], p = 0.314). Women with migraine with aura more often reported increased migraine frequency during pregnancy and breastfeeding compared to women with migraine without aura, but not during hormonal contraception use.ConclusionSex hormone levels seem to differently affect the trigeminovascular system (migraine headache) and the susceptibility to cortical spreading depolarization (aura). Exclusively migraine attacks without aura should be interpreted as perimenstrual attacks.Show less
Menstrual migraine
pregnancy
breastfeeding
hormonal contraception
lactation
All authors
Verhagen, I.E.; Arend, B.W.H. van der; Casteren, D.S. van; Thiermann, N.J.S.; Tange, E.; MaassenVanDenBrink, A.; Terwindt, G.M.
Date
2023-06-01
Journal
Cephalalgia
Volume
43
Issue
6
DOI
doi:10.1177/03331024231164322
Link
https://journals.sagepub.com/doi/10.1177/03331024231164322