title: Migraine in women: the role of hormones and their impact on vascular diseases.
abstract: Migraine is a predominantly female disorder. Menarche, menstruation, pregnancy, and menopause, and also the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. Migraine usually starts after menarche, occurs more frequently in the days just before or during menstruation, and ameliorates during pregnancy and menopause. Those variations are mediated by fluctuation of estrogen levels through their influence on cellular excitability or cerebral vasculature. Moreover, administration of exogenous hormones may cause worsening of migraine as may expose migrainous women to an increased risk of vascular disease. In fact, migraine with aura represents a risk factor for stroke, cardiac disease, and vascular mortality. Studies have shown that administration of combined oral contraceptives to migraineurs may further increase the risk for ischemic stroke. Consequently, in women suffering from migraine with aura caution should be deserved when prescribing combined oral contraceptives.
authors.affiliation: Department of Neurology and Regional Referral Center for Headache Disorders, University of L'Aquila, Piazzale Salvatore Tommasi, 1, 67100, L'Aquila, Italy. simona.sacco@cc.univaq.it
authors.forename: Simona
authors.initials: S
authors.lastname: Sacco
authors.forename: Silvia
authors.initials: S
authors.lastname: Ricci
authors.forename: Diana
authors.initials: D
authors.lastname: Degan
authors.forename: Antonio
authors.initials: A
authors.lastname: Carolei
mesh_terms: D005260:Female; D012739:Gonadal Steroid Hormones / Q000009:adverse effects*; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D008881:Migraine Disorders / Q000209:etiology*; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology*
chemical_list: D012739:Gonadal Steroid Hormones