SEATTLE (Reuters Health) - Where a woman is at in her menstrual cycle may affect whether or not she suffers a migraine, as well as how painful and disabling the headache is, according to a study presented here Monday at the 44th Annual Scientific Meeting of the American Headache Society.

Previous studies have suggested that migraines occur more often during the first half of the menstrual cycle, Dr. Vince Martin of the University of Cincinnatti noted, but studies have not investigated whether other parts of the menstrual cycle have any effect on migraine occurrence. Also, he noted, prior studies have not examined the hormonal aspects of these menstrual phases.

Martin and colleagues studied the headache patterns in 21 women, who ranged in age from 21 to 45 with an average age of 39. All women suffered migraines, and all had regular menstrual cycles lasting from 25 to 35 days. The women kept diaries on their symptoms, recording headache severity and disability three times a day for three consecutive menstrual cycles. Researchers also took urine samples from the women each day, testing them for hormone levels.

The researchers divided the women's cycles into seven different phases, which had not been done previously in studies of headache, Martin noted.

Disability from headache and headache severity differed across all seven menstrual cycle phases, with all measures showing the same pattern.

Headache frequency, disability and severity were worst during the first few days of a woman's menstrual cycle (when menstruation begins), while women had the fewest headaches, as well as the least severe and disabling migraines, toward the end of their cycles. Specifically, headaches were worst during the first of the seven phases, and least common and severe during the second-to-last phase. The frequency and severity of headaches was in between these two extremes at the mid-point of the women's menstrual cycles.

"I think you need to break up the menstrual cycle in various phases to really see what's going on hormonally," said Martin. In the first part of the cycle, there's a rapid drop in levels of the hormones estrogen and progesterone, he noted, while levels of both hormones are relatively stable toward the end of the cycle. But, Martin noted, it's not clear whether the increased severity in headache is due to the drop in hormones, or whether higher levels of progesterone later in the cycle are protective.

He added that a previous study he and his colleagues conducted of the frequency of a certain type of seizure in relation to the menstrual cycle "almost identically" matched the current findings.

Reference Source 89

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