Download PDF
Aktuelle Neurologie 2015; 42(06): 344-350
DOI: 10.1055/s-0035-1554704
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Frauen und Migräne

Women and Migraine
D. Holle
1   Klinik für Neurologie, Universitätsklinikum Essen
,
H.C. Diener
1   Klinik für Neurologie, Universitätsklinikum Essen
› Author Affiliations
Further Information

Publication History

Publication Date:
12 August 2015 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Frauen leiden etwa 3-mal häufiger unter Migräne als Männer. Über die reinen Unterschiede der Prävalenz hinaus unterscheidet sich die „weibliche“ von der „männlichen“ Migräne in zahlreichen weiteren klinischen, prognostischen und pathophysiologischen Aspekten, was in der Therapie beachtet werden muss. So gibt es spezielle Behandlungssituationen wie Migräne in der Schwangerschaft, die menstruelle Migräne mit der Frage der optimalen hormonellen Kontrazeption oder die Menopause, die spezifischer Therapieansätze bedürfen. Zudem gibt es neue Bildgebungsstudien, die zeigen, dass auch morphologische Unterschiede zwischen dem weiblichen und männlichen Migränegehirn bestehen. Dieser Artikel beschäftigt sich mit neuen Erkenntnissen der Migränepathophysiologie und -therapie unter Berücksichtigung frauenspezifischer Gender-Aspekte.

Abstract

Women suffer about 3 times more often from migraine than men. In addition to basic differences in the prevalence of ”female“ and ”male“ migraine, there are also differences in several clinical, prognostic, and pathophysiological aspects, which have to be taken into consideration in therapy. There are distinct treatment situations such as migraine during pregnancy, menstrual migraine with the issue of optimal hormonal contraception as well as in menopause which need distinct therapeutic approaches. Furthermore, there is evidence from imaging studies that the female migraine brain is morphologically different from the male migraine brain. This article focuses on new findings regarding migraine pathophysiology as well as therapy taking gender aspects into account.

Schlüsselwörter

Frauen - Migräne - hormonelle Kontrazeption - Schwangerschaft - vaskuläre Risikofaktoren

Keywords

women - migraine - hormonal contraception - pregnancy - vascular risk factors
 

  • Literatur

  • 1 Stewart WF, Shechter A, Rasmussen BK. Migraine prevalence. A review of population-based studies. Neurology 1994; 44: S17-S23
    PubMedGoogle Scholar
  • 2 Buse DC, Loder EW, Gorman JA et al. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache 2013; 53: 1278-1299
    CrossrefPubMedGoogle Scholar
  • 3 Maleki N, Linnman C, Brawn J et al. Her versus his migraine: multiple sex differences in brain function and structure. Brain 2012; 135: 2546-2559
    CrossrefPubMedGoogle Scholar
  • 4 Maleki N, Barmettler G, Moulton EA et al. Female Migraineurs Show Lack of Insular Thinning with Age. Pain 2015; [Epub ahead of print]
    PubMedGoogle Scholar
  • 5 Granella F, Sances G, Pucci E et al. Migraine with aura and reproductive life events: a case control study. Cephalalgia 2000; 20: 701-707
    CrossrefPubMedGoogle Scholar
  • 6 Cupini LM, Matteis M, Troisi E et al. Sex-hormone-related events in migrainous females. A clinical comparative study between migraine with aura and migraine without aura. Cephalalgia 1995; 15: 140-144
    CrossrefPubMedGoogle Scholar
  • 7 Wainscott G, Sullivan FM, Volans GN et al. The outcome of pregnancy in women suffering from migraine. Postgrad Med J 1978; 54: 98-102
    CrossrefPubMedGoogle Scholar
  • 8 Adeney KL, Williams MA. Migraine headaches and preeclampsia: an epidemiologic review. Headache 2006; 46: 794-803
    CrossrefPubMedGoogle Scholar
  • 9 Adeney KL, Williams MA, Miller RS et al. Risk of preeclampsia in relation to maternal history of migraine headaches. J Matern Fetal Neonatal Med 2005; 18: 167-172
    CrossrefPubMedGoogle Scholar
  • 10 Bánhidy F, Acs N, Horváth-Puhó E et al. Pregnancy complications and delivery outcomes in pregnant women with severe migraine. Eur J Obstet Gynecol Reprod Biol 2007; 134: 157-163
    CrossrefPubMedGoogle Scholar
  • 11 Facchinetti F, Allais G, D’Amico R et al. The relationship between headache and preeclampsia: a case-control study. Eur J Obstet Gynecol Reprod Biol 2005; 121: 143-148
    CrossrefPubMedGoogle Scholar
  • 12 Facchinetti F, Allais G, Nappi RE et al. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia 2009; 29: 286-292
    CrossrefPubMedGoogle Scholar
  • 13 Marcoux S, Bérubé S, Brisson J et al. History of migraine and risk of pregnancy-induced hypertension. Epidemiology 1992; 3: 53-56
    CrossrefPubMedGoogle Scholar
  • 14 Scher AI, Terwindt GM, Picavet HSJ et al. Cardiovascular risk factors and migraine: the GEM population-based study. Neurology 2005; 64: 614-620
    CrossrefPubMedGoogle Scholar
  • 15 Marcus DA, Scharff L, Turk DC. Nonpharmacological management of headaches during pregnancy. Psychosom Med 1995; 57: 527-535
    CrossrefPubMedGoogle Scholar
  • 16 Amundsen S, Nordeng H, Nezvalová-Henriksen K et al. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol 2015; [Epub ahead of print]
    PubMedGoogle Scholar
  • 17 Henderson AJ, Shaheen SO. Acetaminophen and asthma. Paediatr Respir Rev 2013; 14: 9-15 quiz 16
    CrossrefPubMedGoogle Scholar
  • 18 Liew Z, Ritz B, Rebordosa C et al. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatr 2014; 168: 313-320
    CrossrefPubMedGoogle Scholar
  • 19 Mazaud-Guittot S, Nicolas Nicolaz C, Desdoits-Lethimonier C et al. Paracetamol, aspirin, and indomethacin induce endocrine disturbances in the human fetal testis capable of interfering with testicular descent. J Clin Endocrinol Metab 2013; 98: E1757-E1767
    CrossrefPubMedGoogle Scholar
  • 20 Marchenko A, Etwel F, Olutunfese O et al. Pregnancy outcome following prenatal exposure to triptan medications: a meta-analysis. Headache 2015; 55: 490-501
    CrossrefPubMedGoogle Scholar
  • 21 Sándor PS, Di Clemente L, Coppola G et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology 2005; 64: 713-715
    CrossrefPubMedGoogle Scholar
  • 22 Teran E, Hernandez I, Nieto B et al. Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia. Int J Gynaecol Obstet 2009; 105: 43-45
    CrossrefPubMedGoogle Scholar
  • 23 Govindappagari S, Grossman TB, Dayal AK et al. Peripheral nerve blocks in the treatment of migraine in pregnancy. Obstet Gynecol 2014; 124: 1169-1174
    CrossrefPubMedGoogle Scholar
  • 24 Massiou H, MacGregor EA. Evolution and treatment of migraine with oral contraceptives. Cephalalgia 2000; 20: 170-174
    CrossrefPubMedGoogle Scholar
  • 25 Curtis KM, Chrisman CE, Peterson HB. WHO Programme for Mapping Best Practices in Reproductive Health. Contraception for women in selected circumstances. Obstet Gynecol 2002; 99: 1100-1112
    CrossrefPubMedGoogle Scholar
  • 26 MacGregor EA. Contraception and headache. Headache 2013; 53: 247-276
    CrossrefPubMedGoogle Scholar
  • 27 Etminan M, Takkouche B, Isorna FC et al. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ 2005; 330: 63
    CrossrefPubMedGoogle Scholar
  • 28 Schürks M, Rist PM, Bigal ME et al. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ 2009; 339: b3914
    CrossrefPubMedGoogle Scholar
  • 29 Spector JT, Kahn SR, Jones MR et al. Migraine headache and ischemic stroke risk: an updated meta-analysis. Am J Med 2010; 123: 612-624
    CrossrefPubMedGoogle Scholar
  • 30 Allais G, Gabellari IC, De Lorenzo C et al. Oral contraceptives in migraine. Expert Rev Neurother 2009; 9: 381-393
    CrossrefPubMedGoogle Scholar
  • 31 Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: A meta-analysis. JAMA 2000; 284: 72-78
    CrossrefPubMedGoogle Scholar
  • 32 Lidegaard Ø. Hormonal contraception, thrombosis and age. Expert Opin Drug Saf 2014; 13: 1353-1360
    CrossrefPubMedGoogle Scholar
  • 33 Chakhtoura Z, Canonico M, Gompel A et al. Progestogen-only contraceptives and the risk of stroke: a meta-analysis. Stroke 2009; 40: 1059-1062
    CrossrefPubMedGoogle Scholar
  • 34 Mantha S, Karp R, Raghavan V et al. Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis. BMJ 2012; 345: e4944
    CrossrefPubMedGoogle Scholar
  • 35 World Health Organization . Medical Eligibility for Contrazeptive Use. 4th edn. 2010
    Google Scholar
  • 36 Nappi RE, Sances G, Allais G et al. Effects of an estrogen-free, desogestrel-containing oral contraceptive in women with migraine with aura: a prospective diary-based pilot study. Contraception 2011; 83: 223-228
    CrossrefPubMedGoogle Scholar
  • 37 Merki-Feld GS, Imthurn B, Langner R et al. Headache frequency and intensity in female migraineurs using desogestrel-only contraception: a retrospective pilot diary study. Cephalalgia 2013; 33: 340-346
    CrossrefPubMedGoogle Scholar
  • 38 Merki-Feld GS, Imthurn B, Seifert B et al. Desogestrel-only contraception may reduce headache frequency and improve quality of life in women suffering from migraine. Eur J Contracept Reprod Health Care 2013; 18: 394-400
    CrossrefPubMedGoogle Scholar
  • 39 http://www.dmkg.de/sites/default/files/PM-antibabypille-migraene.pdf
    PubMed
  • 40 Headache Classification Committee of the International Headache Society (IHS) . The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33: 629-808
    CrossrefPubMedGoogle Scholar
  • 41 MacGregor EA, Frith A, Ellis J et al. Incidence of migraine relative to menstrual cycle phases of rising and falling estrogen. Neurology 2006; 67: 2154-2158
    CrossrefPubMedGoogle Scholar
  • 42 Machado RB, Pereira AP, Coelho GP et al. Epidemiological and clinical aspects of migraine in users of combined oral contraceptives. Contraception 2010; 81: 202-208
    CrossrefPubMedGoogle Scholar
  • 43 Kvisvik EV, Stovner LJ, Helde G et al. Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pain 2011; 12: 443-451
    CrossrefPubMedGoogle Scholar
  • 44 Nattero G, Allais G, De Lorenzo C et al. Relevance of prostaglandins in true menstrual migraine. Headache 1989; 29: 233-238
    CrossrefPubMedGoogle Scholar
  • 45 Allais G, Rolando S, Schiapparelli P et al. Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine: an open study. Neurol Sci 2013; 34 (Suppl. 01) S179-S181
    CrossrefPubMedGoogle Scholar
  • 46 Brandes JL, Kudrow D, Stark SR et al. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA 2007; 297: 1443-1454
    CrossrefPubMedGoogle Scholar
  • 47 MacGregor EA. A review of frovatriptan for the treatment of menstrual migraine. Int J Womens Health 2014; 6: 523-535
    PubMedGoogle Scholar
  • 48 Géraud G, Keywood C, Senard JM. Migraine headache recurrence: relationship to clinical, pharmacological, and pharmacokinetic properties of triptans. Headache 2003; 43: 376-388
    CrossrefPubMedGoogle Scholar
  • 49 Wade A, Pawsey S, Whale H et al. Pharmacokinetics of two 6-day frovatriptan dosing regimens used for the short-term prevention of menstrual migraine: A phase I, randomized, double-blind, placebo-controlled, two-period crossover, single-centre study in healthy female volunteers. Clin Drug Investig 2009; 29: 325-337
    CrossrefPubMedGoogle Scholar
  • 50 MacGregor EA. Prevention and treatment of menstrual migraine. Drugs 2010; 70: 1799-1818
    CrossrefPubMedGoogle Scholar
  • 51 De Leo V, Scolaro V, Musacchio MC et al. Combined oral contraceptives in women with menstrual migraine without aura. Fertil Steril 2011; 96: 917-920
    CrossrefPubMedGoogle Scholar
  • 52 Somerville BW, Carey HM. The use of continuous progestogen contraception in the treatment of migraine. Med J Aust 1970; 1: 1043-1045
    PubMedGoogle Scholar
  • 53 Vetvik KG, MacGregor EA, Lundqvist C et al. Contraceptive-induced amenorrhoea leads to reduced migraine frequency in women with menstrual migraine without aura. J Headache Pain 2014; 15: 30
    CrossrefPubMedGoogle Scholar
  • 54 Martin VT. Migraine and the menopausal transition. Neurol Sci 2014; 35 (Suppl. 01) 65-69
    CrossrefPubMedGoogle Scholar