Girls in puberty may blame changes in female hormones for triggering headaches. That’s according to a new study from the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital.
Researchers found that higher levels of progesterone were associated with fewer headaches in older teens, and lower levels of progesterone resulted in fewer headaches. Surprisingly, in younger girls, the opposite appears to be true.
“Ours is the first study to show that migraine headaches might also be influenced by female hormones in girls with migraine,” says Vincent Martin, MD, professor in the UC Division of General Internal Medicine and co-director of the Headache and Facial Pain Center at the UC Gardner Neuroscience Institute. “While low and declining estrogen levels are thought to precipitate migraine in adult women we found that progesterone to be the most important trigger factor in these young girls. However, this effect seemed to differ depending on the age of the girls and their pubertal development.”
The Migraine Research Foundation notes that about 10 percent of school age children suffer from migraine. As children enter adolescence the incidence of migraine increases. About 23 percent of girls have experienced migraine, while only about 8 percent of boys have.
The study is available in the online edition of Cephalalgia.
Nationally, about 10 percent of school age children suffer from migraine, according to the Migraine Research Foundation (MRF). As adolescence approaches, the incidence of migraine increases rapidly in girls and by age 17 about 8 percent of boys and 23 percent of girls have experienced migraine, the MRF reports.
“There is a dramatic change in the way that female hormones affect migraine that occurs during puberty,” says Dr. Martin. “Prior to puberty progesterone has little effect on migraine, but after puberty high progesterone levels are associated with fewer headaches and low progesterone levels have more headache.”
Researchers examined 34 girls experiencing migraine distributed across three age groups—ages 8 to 11, 12 to 15 and 16 to 17. Daily urine samples were collected and the occurrence and severity of headaches was recorded in diary for a 90-day period. The urine samples provided metabolites for the hormones estrogen and progesterone.
In the 16 to 17 age group there was a 42 percent chance of having a headache when levels of progesterone were low in urine samples, while when levels of the hormone was higher the chance of headache dropped to 24 percent, Dr. Martin said.
In the 8 to 11 age group, there was 15 percent chance of suffering from migraine or headache when levels of progesterone were low, but a 20 percent chance of migraine or headache when high levels of progesterone were found in the urine, explains Martin.
“The shifting contribution of female hormones to migraine occurrence from pre-pubertal girls through puberty into adulthood suggests a very dynamic process,” says Andrew Hershey, MD, PhD, endowed chair and director of neurology at Cincinnati Children’s Hospital Medical Center. “As the brain is developing in these girls there may be differences in the brain receptors sensitivity and their roles in migraine occurrence. The role of these receptors appear to shift from progesterone to estrogen as these girls progress through puberty. As the brain matures it could respond differently to hormones than a non-maturated brain.”