Eighteen patients suffering from true menstrual migraine and 11 control subjects were studied.

We evaluated in different phases of the menstrual cycle and during the migraine crisis the platelet sensitivity to prostacyclin (PSP) and the platelet content of 5-HT. We also investigated both in basal conditions (follicular phase of the cycle) and during the migraine attack the levels of anxiety and depression. Some personality traits (psychoticism, extroversion and neuroticism) were also analyzed.

The trends observed in the two groups are significantly different for both PSP (p<0.02) and 5-HT (p<0.01).

Our data suggest the hypothesis that a change in platelet homeostasis, mainly evident in the luteal and perimenstrual phases of the cycle, can play a remarkable role in menstrual migraine pathogenesis.

From the psychological point of view, these patients are normal, even if they are significantly less extroverted (p< 0.005), more anxious (p<O.05) and more depressed (p<0.05) than controls.

The clinical features and the cyclic unavoidable recurrence of the menstrual crisis could account for this particular psychological picture.