Migraine: Is it related to hormonal disturbances or stress?


International Journal of Women’s Health, 12/28/2014 Clinical Article

Parashar R, et al. – This study was done to understand the association of hormonal fluctuation in menstruation and stress with common migraine. Migraine, particularly without aura, in women is mainly associated with stress–related anxiety or depression, and are more susceptible to stress in the premenstrual period.

Methods

  • A cross–sectional comparative study was conducted in 40 young adult females, of whom 20 participants were cases of migraine without aura (18–35 years old), and the remaining 20 participants were age–matched controls.
  • The study was done in Maulana Azad Medical College, New Delhi.
  • Study participants were selected on the basis of International Headache Society (ICHD–IIA1.1) (2004) classification.
  • Study participants with neurological disorders, chronic diseases, and disease suggestive of any hormonal disturbances were excluded.
  • Clinically diagnosed migraine cases were asked to maintain a headache diary and to fill in the Depression Anxiety Stress Scales questionnaire.
  • Biochemical assessment of hormonal status for thyroid–stimulating hormone, triiodothyronine, thyroxine, estrogen, follicle–stimulating hormone, luteinizing hormone, and prolactin was also done on the second day of their menstrual cycle.
  • Authors used the Mann–Whitney U test to compare hormonal levels and the Χ2 test to compare anxiety– or depression–related stress among the migraine and nonmigraine groups.

Results

  • Significantly higher values of prolactin were observed in cases (mean ± standard deviation, 152.7 mIU/L±30.5) compared to controls (76.1 mIU/L±8.7), with a P–value <0.001.
  • There was no statistically significant difference observed in levels of thyroid–stimulating hormone (P=0.081), estrogen (P=0.086), luteinizing hormone (P=0.091), or follicle–stimulating hormone (P=0.478).
  • Also, anxiety with stress or depression with stress was significantly higher among the migraine group than the controls (P=0.002).
  • Odds of any stress in migraine were higher in the migraine group than in the nonmigraine group (odds ratio 12, 95% confidence interval 2.7–53.33).

Journal Reference
PubMed Reference

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