There is a link between the female sex hormones, estrogen and progesterone, and migraine.<sup>29 Epstein M.T., Hockaday J.M., Hockaday T.D.R. Migraine and reproductive hormones throughout the menstrual cycle Lancet 1975 ;  1 : 543  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 77 Selby G., Lance J.W. Observation on 500 cases of migraine and allied vascular headaches J Neurol Neurosurg Psychiatry 1960 ;  23 : 23  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 83 Silberstein S.D., Lipton R.B., Goadsby P.J. Headache in Clinical Practice Oxford: Isis Medical Media (1998). 

Cliccare qui per andare alla sezione Riferimenti, 86 Silberstein S.D., Merriam G.R. Sex hormones and headache Headache Newton, MA: Butterworth-Heinemann (1997).  143

Cliccare qui per andare alla sezione Riferimenti</sup> Migraine occurs more frequently in women than in men, although prevalence is equal in prepubertal children. Migraine develops most frequently in the second decade, with the peak incidence occurring at adolescence.<sup>29 Epstein M.T., Hockaday J.M., Hockaday T.D.R. Migraine and reproductive hormones throughout the menstrual cycle Lancet 1975 ;  1 : 543  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 77 Selby G., Lance J.W. Observation on 500 cases of migraine and allied vascular headaches J Neurol Neurosurg Psychiatry 1960 ;  23 : 23  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Menstrually related migraine (MM) begins at menarche in 33% of affected women.<sup>29 Epstein M.T., Hockaday J.M., Hockaday T.D.R. Migraine and reproductive hormones throughout the menstrual cycle Lancet 1975 ;  1 : 543  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> MM occurs mainly at the time of menses in many migrainous women and exclusively with menses (true menstrual migraine [TMM]) in some.<sup>29 Epstein M.T., Hockaday J.M., Hockaday T.D.R. Migraine and reproductive hormones throughout the menstrual cycle Lancet 1975 ;  1 : 543  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> MM can be associated with other somatic complaints arising before and often persisting into menses, such as nausea, backache, breast tenderness, and cramps, and, similar to them, appears to be the result of falling sex hormone levels.<sup>4 American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders Washington, DC: American Psychiatric Association (1994). 

Cliccare qui per andare alla sezione Riferimenti, 86 Silberstein S.D., Merriam G.R. Sex hormones and headache Headache Newton, MA: Butterworth-Heinemann (1997).  143

Cliccare qui per andare alla sezione Riferimenti</sup> Premenstrual migraine can be associated with late luteal phase dysphoric disorder (premenstrual dysphoric disorder, also called premenstrual syndrome [PMS]), which is distinct from the physical symptoms of the perimenstrual period and probably is not driven directly by declining progesterone levels.<sup>59 Mortola J.F. Premenstrual syndrome—pathophysiologic considerations N Engl J Med 1998 ;  338 : 256

Cliccare qui per andare alla sezione Riferimenti</sup> Migraine occurring during (rather than before) menstruation usually is not associated with PMS.

Migraine often worsens during the first trimester of pregnancy. Although many women become headache-free during the last two trimesters, 25% have no change in their migraine.<sup>82 Silberstein S.D. Migraine and pregnancy Neurol Clin 1997 ;  15 : 209  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 86 Silberstein S.D., Merriam G.R. Sex hormones and headache Headache Newton, MA: Butterworth-Heinemann (1997).  143

Cliccare qui per andare alla sezione Riferimenti</sup> MM typically improves with pregnancy.<sup>82 Silberstein S.D. Migraine and pregnancy Neurol Clin 1997 ;  15 : 209  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 86 Silberstein S.D., Merriam G.R. Sex hormones and headache Headache Newton, MA: Butterworth-Heinemann (1997).  143

Cliccare qui per andare alla sezione Riferimenti</sup> Hormonal replacement with estrogens can exacerbate migraine, and oral contraceptives (OCs) can change its character and frequency.<sup>10 Bickerstaff E.R. Neurological Complications of Oral Contraceptives Oxford: Clarendon Press (1975). 

Cliccare qui per andare alla sezione Riferimenti, 46 Kudrow L. The relationship of headache frequency to hormone use in migraine Headache 1975 ;  15 : 36  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Migraine prevalence decreases with advancing age but may regress or worsen at the menopause.<sup>64 Neri I., Granella F., Nappi R.M.G.C. , e al. Characteristics of headache at menopause: A clinico-epidemiologic study Maturitas 1993 ;  17 : 31  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Changes in the headache pattern with OC use and during menarche, menstruation, pregnancy, and menopause are related to changes in estrogen levels. These phenomena suggest a relationship between migraine headaches and changes in sex hormone levels.<sup>52 Lundberg P.O. Endocrine headaches Handbook of Clinical Neurology New York: Elsevier (1986).  431

Cliccare qui per andare alla sezione Riferimenti</sup> This article discusses the endocrinology of the menstrual cycle and approaches to the therapy of hormone-related headaches, in particular headaches associated with the menstrual cycle, the menopause, and OC use.