Eighteen patients suffering from true menstrual migraine and 12 control subjects were studied. We evaluated in different phases of the menstrual cycle and during the migraine crisis the peripheral plasma concentrations of 6-keto-PGF1a (the stable metabolite of PGI2), thromboxane B2 (the stable metabolite of thromboxane A2), PGF2a and PGE2.

The mean values of 6-keto-PGF1a in menstrual migraine sufferers are lower than in normal women throughout the whole cycle. The difference between the trends observed in the two groups is statistically significant (p<0.05). The plasma levels of TXB2 and of PGF2a are similar in the two groups investigated, both n basal conditions and during the attack. The plasma concentrations of PGE2 are slightly lower in migraineurs in basal conditions than in normals. However, during the crisis they increase significantly (plt;0.05). In conclusion, among all the parameters considered, PGE2 seems to play the most important role during the pain phase of the attack.

The results of the present study suggest that a deficit of PGI2, one of the most important protecting agents against ischemia, might be a typical feature of menstrual migraine and might cause in these patients a vascular hypersensitivity to different ischemic stimuli.