title: Hormones, menstrual distress, and migraine across the phases of the menstrual cycle.
abstract: OBJECTIVE
  The primary objectives of the present study were to (1) contrast reproductive hormone levels and ratings of menstrual distress of female migraineurs with those of a control group in each menstrual cycle phase, (2) examine correlations between hormone levels and migraine frequency, severity, and migraine-related disability, and (3) examine correlations between menstrual distress and migraine frequency, severity, and migraine-related disability. A secondary objective was to evaluate the validity of a migraine disability measure modified to reflect 7-day recall.
  
  
  BACKGROUND
  Further controlled, prospective study is needed regarding the temporal relationships between reproductive hormones at each stage of the menstrual cycle and fluctuations in migraine activity across the cycle.
  
  
  METHODS
  Twenty-three women (17 with migraine, 6 control participants) completed laboratory hormone assays and measures of menstrual distress and disability at each phase of one menstrual cycle, and monitored their headache activity daily during the same cycle. Results.-The migraine group evidenced lower premenstrual luteinizing hormone and more menstrual distress symptoms at each phase of the menstrual cycle. Hormones were associated with migraine activity and disability within cycle phases, and across phases in a time-lagged manner. Menstrual distress was associated with ovulatory phase migraine activity and with migraine-related disability across the menstrual cycle. A retrospective 7-day migraine disability measure appeared to be a consistently valid index.
  
  
  CONCLUSIONS
  Both reproductive hormones and menstrually related distress appear to predict migraine activity and disability. These associations were evident not only for perimenstrual migraine, but also for migraine at each phase of the menstrual cycle.
authors.affiliation: Center for Psychological Studies, Nova Southeastern University, Ft. Lauderdale, FL 33314, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Kibler
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Rhudy
authors.forename: Donald B
authors.initials: DB
authors.lastname: Penzien
authors.forename: Jeanetta C
authors.initials: JC
authors.lastname: Rains
authors.forename: G Rodney
authors.initials: GR
authors.lastname: Meeks
authors.forename: William
authors.initials: W
authors.lastname: Bennett
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Dollar
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000097:blood* / Q000502:physiology; D008875:Middle Aged; D008881:Migraine Disorders / Q000097:blood* / Q000503:physiopathology; D012189:Retrospective Studies; D013312:Stress, Physiological / Q000503:physiopathology*
chemical_list: D006728:Hormones; D007986:Luteinizing Hormone