New research reveals a possible mechanism for the cause of migraines, which could explain why women get more migraines than men. The study suggests that sex hormones affect cells around the trigeminal nerve and connected blood vessels in the head, with estrogens — at the highest levels in women of reproductive age — being particularly important for sensitizing these cells to migraine triggers.
“We can observe significant differences in our experimental migraine model between men and women and try to understand the molecular correlates responsible for these differences,” explains Professor Antonio Ferrer-Montiel from Universitas Miguel Hernández, Spain. “Although this is a complex process, we believe that modulation of the trigeminovascular system by sex hormones plays an important role that has not been properly addressed.”
The researchers reviewed decades of literature on sex hormones, migraine susceptibility, and cells' responses to migraine triggers to identify the role of specific hormones. Some (like testosterone) seem to protect against migraines, while others (like prolactin) seem to make migraines worse. They do this by making the cells' ion channels, which regulate the cells' responses to outside stimuli, more or less vulnerable to migraine triggers.
Some hormones need much more research to determine their role. However, estrogen stands out as a key candidate for understanding migraines. It was first identified as a factor due to the greater prevalence of migraine in menstruating women and the association of some types of migraine with period-related changes in hormone levels. The research team's evidence now suggests that estrogen and changes in estrogen levels make cells surrounding the trigeminal nerve sensitive to stimuli. That makes it easier to trigger a migraine.
