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Epidemiology and Biology of Menstrual Migraine

Authors

  • Vincent T. Martin MD,

    1. From the Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V.T. Martin); Departments of Neurology, Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA (R.B. Lipton).
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  • Richard B. Lipton MD

    1. From the Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V.T. Martin); Departments of Neurology, Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA (R.B. Lipton).
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  • Conflict of Interest: Richard B. Lipton, MD has received research grant support from Advanced Bionics, Allergan, GlaxoSmithKline, Merck, Neuralieve, Ortho-McNeil, Pfizer, ProEthics and St. Jude's; has consulted for Advanced Bionics, Allergan, Boehringer-Ingelheim, Bristol Myers Squibb, Cierra, Endo Pharmaceuticals, Neuralieve, Novartis, Ortho-McNeil, Pfizer, Pozen, ProEthics; received honoraria from Allergan, AstraZeneca, GlacoSmithKline, Merck, Neuralieve, Novartis, Ortho-McNeil and Pfizer. Vincent T. Martin, MD has received research grant support from Allergan, Advanced Bionics, GlaxoSmithKline, Merck, Neuralieve, OrthoMcNeil, Pfizer, ProEthics, St. Jude's and is on the Advisory Board/Consulted for Allergan, OrthoMcNeil, Pfizer.

V.T. Martin, Cincinnati Headache Center, University Medical Arts Building, 231 Albert Sabin Way RM 6603, Division of General Internal Medicine, Cincinnati, OH 45267-0535, USA.

Abstract

Migraine is frequently associated with menstruation in female migraineurs, and consequently it is commonly referred to as menstrually associated migraine. The trigger thought to be partially responsible for menstrually associated migraine is a significant drop in circulating estrogen that is noted during 2-3 days prior to onset of menses. It is estimated that approximately 50% of women have an increased risk of experiencing migraine during the premenstrual phase of decreasing estrogen levels. Understanding the biological basis of migraine associated with menses will facilitate an accurate diagnosis and help patients recognize time susceptible to migraine exacerbations. This paper will review the biological bases for the hormonal changes that occur during the menstrual cycle and review the prevalence and burden of menstrual migraine among female headache sufferers.

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