Estrogen, migraine, and vascular risk.


eMediNexus    23 June 2018

A new article published in Neurological Sciences discussed that females have higher propensity for migraine and the course of its symptoms is influenced by life stages, vis, presence of menstrual cycle, pregnancy, puerperium, menopause, and the use of hormone therapy, such as hormonal contraception and hormone replacement therapy. The authors stated that hormonal changes are among common migraine triggers, especially, a sudden estrogen drop. Estrogens can modulate neuronal excitability, through serotonin, norepinephrine, dopamine, and endorphin regulation, and interact with the vascular endothelium of the brain. Although the risk of vascular disease and ischemic stroke is increased in women with migraine with aura, the correlation is unclear. One hypothesis states that migraine may cause clinical or subclinical brain lesions following repeated episodes of cortical spreading depression, whereas, another holds the presence of common risk factors and comorbidities responsible for the association between migraine and vascular diseases. It was stated that estrogens can play a differential role depending on their action on healthy or damaged endothelium, their endogenous or exogenous origin, and the duration of hormonal treatment. Furthermore, platelet activity is increased in female migraineurs, and it is further stimulated by estrogens.

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