| Abstract [eng] |
Migraines affect women significantly more due to hormonal fluctuations throughout a woman's lifespan. This narrative literature review aims to evaluate the role of hormones in the pathophysiology and treatment of migraine. Specifically, hormones such as estrogen, progesterone, prolactin, oxytocin, and gender-affirming hormone therapy. Moreover, the objective is to examine the relationship between hormonal variation and migraine frequency, severity, and clinical presentation. In addition, investigate the neuroendocrine pathways underlying migraine sensitivity. The method used was a primary database such as PubMed/MEDLINE. The sources were gathered using MeSH terms and keywords, with a 20-year time frame (2006-2026). In addition, sources were manually selected for the review. Hormones do impact migraine in varied ways. Of those hormones mentioned previously, estrogen showed an increase in migraine susceptibility due to fluctuations and withdrawal. This dynamic change in estrogen associated with migraines is evident throughout a female’s life cycle, specifically menstrual migraine, postpartum recurrence, and perimenopausal migraine patterns. In contrast, progesterone plays protective and pronociceptive roles depending on the receptor, neurosteroid conversion, and timing. Individuals using gender-affirming hormone therapy as estrogen-based therapy experience an increase in migraines, contrary to testosterone-based therapy. Prolactin has a pronociceptive role increasing calcitonin gene-related peptide signaling. Oxytocin acts in the opposite direction, as it has antinociceptive and anti-inflammatory properties. Regardless of the evidence presented, the heterogeneity of sparse data limits the ability to draw a clear conclusion. Due to the disparity of evidence, extensive research is required to create a definitive conclusion, along with maximizing a treatment regimen using hormones to alleviate migraine. |
