Men With Migraine Likely Have Increased Estradiol Levels

A PPM Brief

Men with migraine were found to have increased levels of estradiol and more likely to have relative androgen deficiency, according to a study out of The Netherlands.¹ Of the many biological factors associated with migraine, sex hormones have been reported as a major contributor. In addition to differences between men and women, migraine prevalence rates and characteristics vary in women by hormonal status (estrogen), further underscoring a strong role for sex hormones in headache.²

Researchers measured 17β-estradiol (E2) and calculated free testosterone (Tf) in the serum of 17 medication-free men with migraine and 22 men without migraine. Androgen deficiency was assessed with the Androgen Deficiency of Ageing Men questionnaire and the Aging Males' Symptoms (AMS) scale (age- and body mass index [BMI]-matched between both groups), along with analyzing interictal data. Blood samples were drawn on a single day at four intervals, and, for participants with migraine, blood was drawn on an interictal day and again 3 to 4 times daily thereafter until an attack occurred.

Many biological factors, including sex hormones, have been reported as a major contributor to migraine. (Source: 123RF)

Researchers found that participants with migraine:

• had a lower interictal Tf/E2 ratio compared with controls (3.9 ± 0.4 vs 5.0 ± 0.3, respectively; P = .03);
• had Tf serum levels similar to those in the control group (357.5 ± 21.4 pmol/L vs 332.6 ± 18.7 pmol/L, respectively; P = .35);
• had higher E2 levels (96.8 ± 6.1 pmol/L vs 69.1 ± 5.6 pmol/L, respectively; P = .001);
• had, in participants who reported premonitory symptoms, increased preictal Tf levels (P = .03);
• and had reported symptoms of androgen deficiency more frequently compared to the control group (61.1% vs 27.3%, respectively; P = .031).

In addition, symptoms were more frequently severe in men with vs without migraine (P = 0.006), with adjusted Aging Males' Symptoms scale scores of 27.0 ± 1.2 for participants with migraine compared with 21.0 ± 1.0 for controls (P = .002).

 “The role of estradiol in modulating migraine susceptibility and activity in men deserves further investigations,” the researchers concluded.