Hormonal fluctuations during menstrual cycle may explain prevalence of migraines in cisgender women

A new study has found that fluctuations in hormonal levels throughout the menstrual cycle are associated with changes in levels of a peptide called calcitonin gene-related peptide (CGRP), which is known to be linked to migraine.

Specifically, the study found that as estrogen levels drop during the onset of menstruation, there is an increase in CGRP levels. This may help explain why many cisgender women experience migraine attacks during menstruation, and why these attacks often decline in frequency after menopause.

The study was conducted at the Headache Center, Department of Neurology, Charité Universitätsmedizin Berlin in Germany. The researchers recruited 180 cisgender women who had experienced at least three episodic migraine attacks in the month leading up to the study. The participants were divided into three groups: those with regular menstrual cycles, those taking contraceptives, and those who had gone through menopause. Age-matched women who did not experience migraines served as a control group.

To assess CGRP levels, the researchers analyzed blood and tear samples taken from study participants. For women with regular menstrual cycles, samples were collected during menstruation and ovulation, when hormone levels are lowest and highest, respectively. For women on birth control, samples were taken at roughly day 4 of the hormone-free interval and its

indings suggest that it could be a promising method for monitoring CGRP levels in the future. Additionally, the study highlights the role of hormonal fluctuations in migraine, and may help pave the way for more targeted treatments for migraine sufferers.

Overall, this study provides new insights into the relationship between hormonal fluctuations and migraine, and sheds light on the biological mechanisms behind menstrual migraine. By identifying CGRP as a potential culprit in menstrual migraine attacks, researchers may be able to develop more targeted treatments for this condition, improving the quality of life for millions of migraine sufferers.

The study’s lead author, Dr. Paolo Martelletti, explains that the findings may also shed light on why menstrual migraines decline in frequency after menopause. He says that “menopause is associated with a reduction in estrogen levels, so the increase in CGRP that we see in premenopausal women during menstruation may no longer occur.”

The study was conducted at the Headache Center, Department of Neurology, Charité Universitätsmedizin Berlin in Germany. The researchers recruited 180 cisgender women who had experienced at least three migraine attacks in the month leading up to the study. The participants were evenly divided into three groups: women with regular menstrual cycles, women taking contraceptives, and women who had gone through menopause. Age-matched women who did not get migraines served as a control group.

To assess levels of CGRP, the researchers analyzed blood and tear samples taken from the study participants. They collected samples from women with regular menstrual cycles during menstruation and ovulation, when hormone levels are lowest and highest, respectively. For women on birth control, they collected samples at roughly day 4 of the participants’ hormone-free intervals, and again during days 7–14 of their hormone intake. Samples were taken just once from women post-menopause, on a random day.

The researchers found that women with migraine and regular menstrual cycles had significantly higher levels of CGRP in their blood during menstruation than women who did not get migraines. During ovulation, the time at which hormone levels are at their highest, CGRP levels decreased, aligning with the cessation of migraine attacks that typically occurs after menstruation. The same patterns held true for tear samples, an experimental form of CGRP.

Overall, this study provides important insights into the role of CGRP in menstrual migraines and may pave the way for the development of targeted treatments for this debilitating condition. With further research, it may be possible to develop medications that specifically target CGRP, providing relief for those who experience menstrual migraines. Additionally, the use of tear sampling as a non-invasive means of measuring CGRP may offer a valuable tool for diagnosing and monitoring migraine in the future.