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Estrogens and migraine

Damasio H, Corbett JJ

Annals of neurology, 1981

Abstract

A worsening of migraine headaches has been associated with estrogens, given for birth control and menopausal syndrome. It is suggested in this case history report that the same may be true in the male migrainous patient, in whom estrogens are rarely used. 1 week following surgery for prostatic carcinoma a 75-year-old white man who was started on stilbestrol 5 mg daily began to experience severe bifrontal, throbbing headaches with nausea and occasional vomiting. The headaches lasted 4-6 hours and appeared 3 or 4 times weekly. Fortification spectra in both visual fields and language disturbances occurred during the headache period. Stilbestrol was discontinued 4 months later, and the headaches improved. After 1 week without headaches, stilbestrol was begun again and similar headaches promptly recurred. Stilbestro was again discontinued, and the headaches immediately improved. 1 month later the patient was free from headache and has since remained so. Between the periods of headache, neurological examination was normal. The patient had a history of moderate common migraine, but following estrogen medication his symptoms became those of a severe clsssic migraine. The case raises the possiblity that the relation between estrogens and migraines is not limited to a fall in estrogen blood levels; steady or rising levels of estrogens possibly produce a similar effect.

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