title: Sex hormones in women with and without migraine: Evidence of migraine-specific hormone profiles.
abstract: OBJECTIVE
  To compare daily sex hormone levels and rates of change between women with history of migraine and controls.
  
  
  METHODS
  History of migraine, daily headache diaries, and daily hormone data were collected in ovulatory cycles of pre- and early perimenopausal women in the Study of Women's Health Across the Nation. Peak hormone levels, average daily levels, and within-woman day-to-day rates of decline over the 5 days following each hormone peak were calculated in ovulatory cycles for conjugated urinary estrogens (E1c), pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone. Comparisons were made between migraineurs and controls using 2-sample t tests on the log scale with results reported as geometric means.
  
  
  RESULTS
  The sample included 114 women with history of migraine and 223 controls. Analyses of within-woman rates of decline showed that E1c decline over the 2 days following the luteal peak was greater in migraineurs for both absolute rate of decline (33.8 [95% confidence interval 28.0-40.8] pg/mgCr vs 23.1 [95% confidence interval 20.1-26.6] pg/mgCr, p = 0.002) and percent change (40% vs 30%, p < 0.001). There was no significant difference between migraineurs and controls in absolute peak or daily E1c, pregnanediol-3-glucuronide, luteinizing hormone, and follicle-stimulating hormone levels. Secondary analyses demonstrated that, among migraineurs, the rate of E1c decline did not differ according to whether a headache occurred during the cycle studied.
  
  
  CONCLUSIONS
  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.
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle. jpavlovi@montefiore.org.
authors.forename: Jelena M
authors.initials: JM
authors.lastname: Pavlović
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Allshouse
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Nanette F
authors.initials: NF
authors.lastname: Santoro
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Sybil L
authors.initials: SL
authors.lastname: Crawford
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Genevieve S
authors.initials: GS
authors.lastname: Neal-Perry
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
authors.affiliation: From the Departments of Neurology (J.M.P., R.B.L., C.A.D.) and Epidemiology and Population Health (R.B.L., C.A.D.), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY; Department of Obstetrics and Gynecology (A.A.A., N.F.S.), University of Colorado Denver, Aurora; Division of Preventive and Behavioral Medicine (S.L.C.), Department of Medicine, University of Massachusetts Medical Center, Worcester; Department of Psychiatry (R.C.T.), University of Pittsburgh, PA; and Division of Reproductive Endocrinology and Infertility (G.S.N.-P.), Department of Obstetrics and Gynecology, University of Washington, Seattle.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Derby
mesh_terms: D000328:Adult; D004967:Estrogens / Q000652:urine*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000652:urine*; D006801:Humans; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000652:urine*; D008593:Menopause / Q000652:urine; D008597:Menstrual Cycle / Q000652:urine; D008875:Middle Aged; D008881:Migraine Disorders / Q000652:urine*; D010507:Periodicity; D011276:Pregnanediol / Q000031:analogs & derivatives* / Q000652:urine
chemical_list: D004967:Estrogens; C022270:pregnanediol-3 alpha-glucuronide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D011276:Pregnanediol