Case study| Volume 50, P165-171, April 2018

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Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients

Published:January 22, 2018DOI:


      • The hormone levels in the HPG axis were abnormal in migraineurs.
      • The change of sex hormones had a significant correlation with the level of disability caused by the migraine.
      • The relationship between hormone levels and migraine related clinical characteristic was more apparent in female migraineur.


      The incidence of migraine is higher in women than in men. Abnormality of the hypothalamus-pituitary-gonadal (HPG) axis is believed to be implicated in the pathogenesis of migraine. The aim of this study was to detect serum hormone levels in the HPG axis of migraineurs and analyze the relationship between the hormone levels and migraine-related clinical characteristics. One hundred and nineteen migraineurs were enrolled. Serum FSH, LH, estradiol, progesterone, testosterone, prolactin and GnRH was detected. Pain intensity and migraine-related disability were evaluated using the visual analogue scale (VAS) and the Migraine Disability Assessment questionnaire (MIDAS). The relationships between sex hormone levels and the VAS score and the MIDAS score were also examined. Progesterone levels in male migraineurs were lower than those in healthy controls (P < .01). In female patients, in the follicular phase, testosterone levels were lower than in healthy controls (P < .01). In the luteal phase, estrogen and testosterone levels (P < .05) were lower than in healthy controls. Progesterone and testosterone levels (P < .01) were lower than in healthy controls in the postmenopausal phase. In male patients, estrogen levels were negatively associated with the MIDAS score (r = −0.602). In female patients, in the follicular phase, estrogen levels were positively correlated with headache duration and VAS score (r = 0.374, r = 0.331, respectively) and negatively related with MIDAS score (r = −0.334). In the luteal phase, estrogen and progesterone levels were negatively correlated with the MIDAS score (r = −0.772, r = −0.464, respectively). The levels of HPG axis hormones were abnormal in migraineurs and were associated with migraine-related clinical characteristics.


      CGRP (calcitonin gene related peptide), E2 (Estrogen), FP (follicular phase), GABA (gamma-aminobutyric acid), HPG (hypothalamus-pituitary-gonadal), LH (luteinizing hormone), NO (nitric oxide), PRG (Progesterone), To (Testosterone), VAS (visual analogue scale), CSD (cortical spreading depression), fMRI (functional magnetic resonance imaging), FSH (follicle stimulating hormone), GnRH (gonadotropin-releasing hormone), LP (luteal phase), MIDAS (Migraine Disability Assessment questionnaire), PMP (postmenopausal phase), PRL (prolactin), TTH (tension-type headache)


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