Ovarian Hormones and Migraine Headache: Understanding Mechanisms and Pathogenesis—Part I


  • Vincent T. Martin MD,

  • Michael Behbehani PhD

  • From the Department of Internal Medicine (Dr. Martin), and Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, Cincinnati, OH (Dr. Behbehani).

Address all correspondence to Dr. Vincent T. Martin, Division of General Internal Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML 6603, Cincinnati, OH 45267-4217.


Ovarian hormones have a significant effect on the central nervous system of female migraineurs. Reproductive milestones such as menarche, pregnancy, and menopause are associated with changes in the clinical course of migraine headache. Migraine attacks are commonly triggered during declines in serum estrogen levels that occur before and during the time of menstruation. Therefore, substantial clinical evidence suggests that changes in ovarian hormones affect migraine headache. This represents the first of two manuscripts defining the role of ovarian hormones in the pathogenesis of migraine headache. The purpose of the first article will be to review the molecular and neurophysiologic effects of estrogen and progesterone on neurotransmitter systems and pain processing networks relevant to migraine headache. The second manuscript will focus on the clinical studies detailing the influence of estrogen and progesterone on migraine headache.