Menstrual cycle and gynecologic pathology in menstrual-related migraine

E. A. Kiryanova, Г. Р. Табеева
In: Neurology, Neuropsychiatry, Psychosomatics · 2021 · vol. 13(4) , pp. 12–17 · doi:10.14412/2074-2711-2021-4-12-17 · W3194913171
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Women with menstrual-related migraine experienced heavier and longer menstrual bleeding, irregular cycles, dysmenorrhea, and a higher incidence of estrogen-associated gynecological pathologies compared to those with non-menstrual migraine.

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This prospective comparative study evaluated 69 reproductive-age women with migraine who were not using hormonal contraception, dividing them into menstrual-related migraine (MRM; 44) versus non-menstrual migraine (25) based on headache diaries. Women with MRM reported heavier and longer menses (>6 days), menstrual cycle abnormalities in length and regularity, and dysmenorrhea, and the authors also found a higher presence of estrogen-associated gynecologic conditions including endometriosis, adenomyosis, endometrial polyps, and myoma. The paper’s limitation is that the findings are observational/prospective but rely on diary-based classification and do not establish causal mechanisms, with the conclusion framed as “presumably” involving hypothalamic–pituitary–ovarian axis dysfunction. This paper is centrally about endometriosis — it reports endometriosis as a comorbid estrogen-associated gynecologic pathology in women with menstrual-related migraine.

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Abstract

Migraine is the first most frequent cause of disability among women of reproductive age globally, and up to 60% of patients note the association of headache attacks with menstruation. Objective : to determine the features of menstrual cycle and gynecologic pathology in women with menstrual-related migraine (MRM). Patients and methods . A prospective comparative study included 69 women of reproductive age with a migraine diagnosis who did not receive hormonal contraception. Depending on the association of migraine attacks with menstruation (according to headache diaries), the patients were divided into two groups: the 1 st group consisted of 44 patients with MRM; group 2 — 25 patients with non-menstrual migraine (without the association of attacks with menstruation). Results and discussion . Patients with MRM had heavier menstrual bleeding, longer menstruations (more than six days), abnormal menstrual cycle length and regularity, dysmenorrhea. In addition, the obtained data indicate a comorbid estrogen-associated gynecological pathology (endometriosis, adenomyosis, endometrial polyps, myoma) in MRM. Conclusion . Presumably, the hypothalamic-pituitary-ovarian axis dysfunction plays the leading role in the MRM. It presents with menstrual cycle abnormalities and increased presence of estrogen-associated gynecological pathology, which should be considered during patient evaluation and suggesting recommendations.
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Abstract

Migraine is the first most frequent cause of disability among women of reproductive age globally, and up to 60% of patients note the association of headache attacks with menstruation.

Objective

to determine the features of menstrual cycle and gynecologic pathology in women with menstrual-related migraine (MRM). Patients and methods. A prospective comparative study included 69 women of reproductive age with a migraine diagnosis who did not receive hormonal contraception. Depending on the association of migraine attacks with menstruation (according to headache diaries), the patients were divided into two groups: the 1st group consisted of 44 patients with MRM; group 2 — 25 patients with non-menstrual migraine (without the association of attacks with menstruation).

Results

and discussion. Patients with MRM had heavier menstrual bleeding, longer menstruations (more than six days), abnormal menstrual cycle length and regularity, dysmenorrhea. In addition, the obtained data indicate a comorbid estrogen-associated gynecological pathology (endometriosis, adenomyosis, endometrial polyps, myoma) in MRM. Conclusion. Presumably, the hypothalamic-pituitary-ovarian axis dysfunction plays the leading role in the MRM. It presents with menstrual cycle abnormalities and increased presence of estrogen-associated gynecological pathology, which should be considered during patient evaluation and suggesting recommendations. About the Authors E. A. KiryanovaRussian Federation Ekaterina Andreevna Kiryanova. 11, Rossolimo St., Build. 1, Moscow 119021. Competing Interests: There are no conflicts of interest. G. R. Tabeeva Russian Federation 11, Rossolimo St., Build. 1, Moscow 119021. Competing Interests: There are no conflicts of interest.

References

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Estrogen receptors in pain modulation: cellular signaling. Biol Sex Differ. 2021 Feb 10;12(1):22. doi: 10.1186/s13293-021-00364-5 25. Karsan N, Goadsby PJ. Biological insights from the premonitory symptoms of migraine. Nat Rev Neurol. 2018 Dec;14(12):699-710. doi: 10.1038/s41582-018-0098-4 26. Schulte LH, May A.The migraine generator revisited: continuous scanning of the migraine cycle over 30 days and three spontaneous attacks. Brain. 2016;139(Pt 7):1987-93. doi: 10.1093/brain/aww097 Review For citations: Kiryanova EA, Tabeeva GR. Menstrual cycle and gynecologic pathology in menstrual-related migraine. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(4):12-17. (In Russ.) https://doi.org/10.14412/2074-2711-2021-4-12-17 JATS XML

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