RESEARCH - Potential role of female sex hormones in the pathophysiology of migraine

[Guest guest]

Pharmacol Ther. 2007 Feb;113(2):321-40. Epub 2006 Oct 25.

Potential role of female sex hormones in the pathophysiology of migraine.

Department of Pharmacology, Erasmus MC, University Medical Center Rotterdam,

P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.

Clinical evidence indicates that female sex steroids may contribute to the

high prevalence of migraine in women, as well as changes in the frequency or

severity of migraine attacks that are in tandem with various reproductive

milestones in women's life. While female sex steroids do not seem to be

involved in the pathogenesis of migraine per se, they may modulate several

mediators and/or receptor systems via both genomic and non-genomic

mechanisms; these actions may be perpetuated at the central nervous system,

as well as at the peripheral (neuro)vascular level. For example, female sex

steroids have been shown to enhance: (i) neuronal excitability by elevating

Ca(2+) and decreasing Mg(2+) concentrations, an action that may occur with

other mechanisms triggering migraine; (ii) the synthesis and release of

nitric oxide (NO) and neuropeptides, such as calcitonin gene-related peptide

CGRP, a mechanism that reinforces vasodilatation and activates trigeminal

sensory afferents with a subsequent stimulation of pain centres; and (iii)

the function of receptors mediating vasodilatation, while the responses of

receptors inducing vasoconstriction are attenuated. The serotonergic,

adrenergic and gamma-aminobutyric acid (GABA)-ergic systems are also

modulated by sex steroids, albeit to a varying degree and with potentially

contrasting effects on migraine outcome. Taken together, female sex steroids

seem to be involved in an array of components implicated in migraine

pathogenesis. Future studies will further delineate the extent and the

clinical relevance of each of these mechanisms, and will thus expand the

knowledge on the femininity of migraine.

PMID: 17069890

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=17069890

Not an MD