Women experience migraine headaches three times more often than men . Migraine affects as many as 37% of reproductive-age women in the United States . Migraines that occur during the menstrual cycles are resistant to treatment and lead to significant functional disability. Management of migraine in women has long been a clinical challenge. A common belief about the cause of migraines in women is the fluctuation of the hormones estrogen and progesterone. In the normal menstrual cycle, estrogen rises rapidly during the first half, called the follicular phase, until mid-cycle where the levels dip prior to ovulation.
Progesterone is only produced after ovulation. During the second half of the cycle, or luteal phase, the levels of both estrogen and progesterone fluctuate markedly. Estrogen rises again and progesterone increases until both peaks at day 23, which is 5 days prior to menstruation. If no fertilization occurs, the levels of estrogen and progesterone rapidly fall. The fall in the estrogen can trigger menstrual-related migraine headaches. Similarly, women who take combined estrogen and progesterone oral contraceptives (COCs) often experience migraines during the hormone-free interval. The fall in the estrogen caused by taking the placebo pills can trigger migraines.
Last date updated on April, 2025