Estrogen withdrawal in the late luteal phase, low serum levels of estrogen or progesterone, and increased uterine prostaglandin release could precipitate headache during the menopausal transition, said the researchers. These hormonal changes also may change the characteristics of the menstrual cycle, which could in turn affect headache frequency.
An advantage of the cross-sectional analysis is that it was a large population-based study of persons with migraine “that should have wide generalizability to the general population,” said Dr. Martin. The outcome measure of high-frequency headache, however, was not limited to migraine, but included all headaches. In addition, headache frequency was self-reported, and investigators did not confirm it with daily headache diaries. Finally, the researchers did not account or control for aura. “Our results should be considered preliminary until confirmed in future studies,” Dr. Martin concluded.
—Erik Greb