Migraine more often occurs in women than in men. Many women also find that their menstrual cycle has an effect on their migraine with the so-called menstrual migraine being more severe.
The sex hormone estrogen has long been known to play a role in migraine but researchers have not been certain on how the link works.
Findings of a new study, however, have shown that the levels of estrogen in women with history of migraine may drop more rapidly in days just before their menstruation compared with their counterparts who did not suffer from migraine headaches. This suggests that there's a process that links estrogen withdrawal and menstrual migraine.
"These results suggest that a 'two-hit' process may link estrogen withdrawal to menstrual migraine," said study researcher Jelena Pavlovic, from Albert Einstein College of Medicine.
Pavlovic further explained that rapid decline of estrogen can make women vulnerable to the common triggers for migraine attacks such as lack of sleep, stress, food and wine.
For the research published in the journal Neurology on June 1, Pavlovic and colleagues analyzed urine samples from 114 women with migraines and 223 without the disorder, who were 47 years old on average.
Using first morning urine samples taken daily for one menstrual cycle, or 50 days, the researchers found that the levels of estrogen among migraine sufferers dropped by 40 percent in days just before their menstruation.
Estrogen levels among those without migraine, on the other hand, only dropped by 30 percent. The difference remained significant even after the researchers adjusted for demographics.
"Migraineurs are characterized by faster late luteal phase E1c decline compared to controls. The timing and rate of estrogen withdrawal before menses may be a marker of neuroendocrine vulnerability in women with migraine," the researchers wrote in their study.
Figures from the American Migraine Foundation show that 36 million Americans, or about 12 percent of the population, suffer from migraine, a condition marked by headaches, nausea, vomiting and sensitivity to light, sound and smell.
Up to 30 percent of women get migraine over the course of their lifetime. Individuals who suffer from migraine are at increased risk for depression, sleep disorder, anxiety, pain conditions and fatigue.
In April, the American Academy of Neurology updated guidelines to recommend the use of botox, which is popularly used for cosmetic purposes, as an effective and safe treatment for chronic migraine.