Department of Neurology and Regional Referral Center for Headache Disorders, University of L'Aquila, Piazzale Salvatore Tommasi, 1, 67100, L'Aquila, Italy.
J Headache Pain. 2012 Apr;13(3):177-89. doi: 10.1007/s10194-012-0424-y. Epub 2012 Feb 26.
Migraine is a predominantly female disorder. Menarche, menstruation, pregnancy, and menopause, and also the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. Migraine usually starts after menarche, occurs more frequently in the days just before or during menstruation, and ameliorates during pregnancy and menopause. Those variations are mediated by fluctuation of estrogen levels through their influence on cellular excitability or cerebral vasculature. Moreover, administration of exogenous hormones may cause worsening of migraine as may expose migrainous women to an increased risk of vascular disease. In fact, migraine with aura represents a risk factor for stroke, cardiac disease, and vascular mortality. Studies have shown that administration of combined oral contraceptives to migraineurs may further increase the risk for ischemic stroke. Consequently, in women suffering from migraine with aura caution should be deserved when prescribing combined oral contraceptives.
偏头痛主要为女性疾病。月经初潮、月经周期、妊娠、绝经期，以及激素避孕和激素替代疗法的应用均可能影响偏头痛的发生。偏头痛通常在月经初潮后出现，在月经前或月经期更为频繁，并在妊娠和绝经期缓解。这些变化是通过雌激素水平的波动来介导的，其通过影响细胞兴奋性或脑血管来实现。此外，外源性激素的应用可能导致偏头痛恶化，使偏头痛女性面临更高的血管疾病风险。事实上，有先兆偏头痛是中风、心脏病和血管死亡率的一个危险因素。研究表明，给予偏头痛患者复方口服避孕药可能进一步增加缺血性中风的风险。因此，对于有先兆偏头痛的女性，在开具复方口服避孕药时应谨慎。
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