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Migraine attacks linked to hormone levels in women

Doctors said migraines are more likely to strike during menstruation.

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By Alice Clifford via SWNS

Migraine attacks are linked to hormone levels in women, according to a new study.

They are more likely to strike during menstruation as low estrogen levels paired with a rise in a specific protein can "jump-start" severe headaches, scientists said.

The hormone estrogen fluctuates throughout a woman’s cycle, hitting its lowest level during a woman’s period.

Just as estrogen levels change, so does the protein calcitonin gene-related peptide (CGRP), a protein that plays a key role in starting migraines.

However, the level of CGRP is at its highest during menstruation. The combination of low estrogen and high CGRP could kick start migraines, making them more common during a woman’s period.

Study author Dr. Bianca Raffaelli, from Charité – Universitätsmedizin Berlin, one of Europe's largest university hospitals, said: “This elevated level of CGRP following hormonal fluctuations could help to explain why migraine attacks are more likely during menstruation and why migraine attacks gradually decline after menopause.

“These results need to be confirmed with larger studies, but we’re hopeful that they will help us better understand the migraine process.”

The researchers studied three groups of women who suffer from episodic migraines.

Each person suffered for at least three days with a migraine the month before the study took place.

The groups included women with a regular menstrual cycle, those taking oral contraceptives and those who had gone through the menopause.

They were all then compared to another set of women of a similar age who did not suffer from migraines.

Each group was made up of 30 people, with a total of 180 participants taking part in the study.

The team collected blood and tear fluid to find out their CGRP levels.

In those with regular menstrual cycles, the samples were taken during menstruation when estrogen levels were low and around the time of ovulation when the levels were at their highest.

For those taking oral contraceptives, samples were taken during the hormone break and during the time when the hormone was being taken.

Samples were taken once from postmenopausal women at a random time.

The women who had a regular menstrual cycle and suffered from migraines had much higher concentrations of CGRP during their period than those who did not suffer from severe headaches.

The blood samples showed that those with migraines had CGRP levels of 5.95 picograms per milliliter (pg/ml), while those without migraines had 4.61 pg/ml.

When studying the tear fluid, they found that those who suffered from migraines had 1.2 nanograms per milliliter (ng/ml) of CGRP while those without migraines only had 0.4 ng/ml.

In contrast, women who took oral contraceptives or were in postmenopause had similar CGRP levels in the migraine and non-migraine groups.

Dr. Raffaelli said: “The study also suggests that measuring CGRP levels through tear fluid is feasible and warrants further investigation, as accurate measurement in the blood is challenging due to its very short half-life.

“This method is still exploratory, but it is non-invasive.”

The team acknowledges that while hormone levels were taken around the time of ovulation, they may not have been gathered on exactly the right day, meaning the fluctuations in estrogen may not be fully accurate.

The study was published in the journal Neurology.

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