Broner Susan W, Bobker Sarah, Klebanoff Louise
Department of Neurology, Weill Cornell Medical College, New York, New York.
Semin Neurol. 2017 Dec;37(6):601-610. doi: 10.1055/s-0037-1607393. Epub 2017 Dec 21.
Migraine is one of the most common neurological disorders, affecting women disproportionally at a rate of 3:1. Prior to puberty, boys and girls are equally affected, but the female preponderance emerges after puberty. Migraine pathophysiology is not fully understood, and although the hormonal effect of estrogen is significant, other factors are at play. This article will focus on the hormonal influence on migraine in women. Here we review our most recent understanding of migraine and menstrual migraine, including epidemiology, pathophysiology, and treatment strategies for this challenging disorder, as well as migraine during pregnancy, postpartum period, breastfeeding, perimenopause, and menopause. We also review the risks and benefits of exogenous hormone use in this population and discuss stroke risk in women with migraine aura. By understanding these aspects of migraine in women, we hope to arm practitioners with the knowledge and tools to help guide treatment of this debilitating disorder in this large population.
偏头痛是最常见的神经系统疾病之一，女性患病率不成比例地高达3:1。青春期前，男孩和女孩受影响的几率相同，但青春期后女性患病率开始占优势。偏头痛的病理生理学尚未完全了解，尽管雌激素的激素作用显著，但其他因素也在起作用。本文将重点探讨激素对女性偏头痛的影响。在此，我们回顾了对偏头痛和月经性偏头痛的最新认识，包括这种具有挑战性疾病的流行病学、病理生理学和治疗策略，以及孕期、产后、哺乳期、围绝经期和绝经后的偏头痛情况。我们还回顾了该人群使用外源性激素的风险和益处，并讨论了有偏头痛先兆的女性的中风风险。通过了解女性偏头痛的这些方面，我们希望为从业者提供知识和工具，以帮助指导对这一庞大人群中这种使人衰弱疾病的治疗。
