From the Guidelines
Migraines in women are most likely caused by hormonal fluctuations, particularly changes in estrogen levels during menstruation, as stated in the most recent study 1.
Key Factors
- Hormonal fluctuations, especially during menstruation, are a significant predisposing factor for migraines in women 1.
- Other triggers may include stress, certain foods and beverages, environmental factors, sleep disruptions, dehydration, and skipping meals.
- Women are genetically more susceptible to migraines, with a family history increasing risk 1.
- Certain medications, including oral contraceptives, can trigger migraines in some women.
- Comorbidities such as anxiety, depression, sleep disturbances, and chronic pain conditions are common in people with migraine and can influence drug choice 1.
Management and Prevention
- Keeping a migraine diary to identify personal triggers and maintaining regular sleep, meal, and exercise routines can help reduce frequency and severity of attacks.
- Lifestyle changes, such as avoiding triggers and managing stress, can benefit patients with migraines.
- Recognition of comorbid conditions is important because they can influence drug choice and improve treatment outcomes for migraine 1.
- Preventive therapy should be considered if the patient has more than two headaches per week 1.
From the Research
Causes of Migraines in Women
The most likely causes of migraines in women are related to hormonal fluctuations and changes throughout their life cycle. Some of the key factors that contribute to migraines in women include:
- Menarche, menstruation, pregnancy, and menopause, which can influence migraine occurrence 2, 3, 4
- The use of hormonal contraceptives and hormone replacement treatment, which may worsen migraine symptoms and increase the risk of vascular disease 2, 3, 4
- Fluctuations in estrogen levels, which can affect cellular excitability and cerebral vasculature, leading to migraine attacks 2, 3, 4
Hormonal Influence on Migraines
Hormonal changes play a significant role in the development and frequency of migraines in women. Studies have shown that:
- Migraine usually starts after menarche and occurs more frequently in the days just before or during menstruation 2, 3
- Migraine symptoms often ameliorate during pregnancy and menopause 2, 3
- The administration of exogenous hormones, such as combined oral contraceptives, can increase the risk of ischemic stroke in women with migraine with aura 2, 3
Other Factors
While hormonal fluctuations are a significant contributor to migraines in women, other factors may also play a role. These include: