Epstein M T, Hockaday J M, Hockaday T D
Lancet. 1975 Mar 8;1(7906):543-8. doi: 10.1016/s0140-6736(75)91558-5.
In a clinical survey the relation between migraine and menstruation was studied in 142 otherwise healthy women. In 24, onset of migraine coincided with the year of menarch. Of the 138 patients in whom onset of migraine predated the menopause, there were only 13 in whom attacks occurred regularly, and only, just before or during menstruation; in a further 11 attacks occurred regularly in relation to menstruation and at other times. Those with menstrually related migraine were more likely to have onset of migraine at menarche, to have associated weight gain and breast discomfort as part of a periodic syndrome, and to show improvement during pregnancy. There appeared no clear pattern of change at the menopause. In a study of reproductive hormones, blood was collected daily throughout a menstrual cycle from each of 8 women with menstrually related migraine, 6 with menstrually non-related migraine, and 8 healthy headache-free controls. Plasma levels of follicle-stimulating hormone (F.S.H.), luteinising hormone (L.H.), prolactin, oestrogen, and progesterone were measured in all. Plasma-testosterone was measured in 8 migraine patients. Mean plasma oestrogen and progesterone levels were significantly higher in migraine patients than controls for most of the menstrual cycle, with the most striking differences found in the late luteal phase for progesterone. No significant difference was found between the menstrually related and non-related patients for these or the other hormones measured. Mean plasma-prolactin levels were lower in migraine subjects than controls, but the difference was not significant. Mean plasma F.S.H. and L.H. levels were similar in both migraine and control groups. Plasma-testosterone levels were within the range for normal in the 8 migraine patients studied. No specific hormone changes were associated with the occurrence of a migraine attack, nor did rising or falling levels, or greater increments of change over given cycle phases, appear important in provoking attacks.
在一项临床调查中，对142名其他方面均健康的女性研究了偏头痛与月经之间的关系。在24名女性中，偏头痛的发作与初潮年份相符。在偏头痛发作早于绝经的138名患者中，只有13名患者的发作规律，且仅在月经前或月经期间发作；另有11名患者的发作与月经有关且规律，但在其他时间也会发作。与月经相关的偏头痛患者在初潮时更易出现偏头痛发作，更易伴有体重增加和乳房不适等周期性综合征症状，且在孕期症状会有所改善。绝经时似乎没有明显的变化模式。在一项生殖激素研究中，在一个月经周期内每天采集8名与月经相关的偏头痛女性、6名与月经无关的偏头痛女性以及8名无头痛的健康对照者的血液。对所有人都检测了血浆卵泡刺激素（F.S.H.）、黄体生成素（L.H.）、催乳素、雌激素和孕激素水平。对8名偏头痛患者检测了血浆睾酮水平。在月经周期的大部分时间里，偏头痛患者的平均血浆雌激素和孕激素水平显著高于对照组，在黄体晚期孕激素的差异最为显著。对于这些或其他检测的激素，与月经相关和无关的患者之间未发现显著差异。偏头痛患者的平均血浆催乳素水平低于对照组，但差异不显著。偏头痛组和对照组的平均血浆F.S.H.和L.H.水平相似。在研究的8名偏头痛患者中，血浆睾酮水平在正常范围内。没有特定的激素变化与偏头痛发作相关，在给定的周期阶段，激素水平的上升或下降，或更大的变化增量，似乎也不是诱发发作的重要因素。
