BERLIN, Germany — When that time of the month rolls around for women, it usually comes with annoying symptoms like cravings, cramps, and headaches. Migraines are a particular problem for women around or during their period. Overall, they affect women at triple the rate of men. A team in Berlin is now revealing why, finding that women with migraines tend to have higher levels of the migraine-triggering neurotransmitter calcitonin gene-related peptide (CGRP) during menstruation.
“Animal models suggest that fluctuations in female hormones, especially estrogen, lead to an increased release of CGRP, an inflammatory neurotransmitter, in the brain,” explains study lead Dr. Bianca Raffaelli of the Headache Center at the Department of Neurology with Experimental Neurology at Charité – Universitätsmedizin Berlin’s Mitte campus, in a media release. “CGRP’s full name is calcitonin gene-related peptide. It is a naturally occurring substance in the body, and when a person has a migraine attack, increasing levels are released, significantly dilating – or widening – the blood vessels in the brain. This causes an inflammatory response that could be one of the reasons behind the severe headaches people experience with migraine.”
To conduct their work, the Charité researchers studied a total of 180 women to see if a relationship exists between female hormones and the release of CGRP in humans as well. They tested CGRP levels in migraine patients at two points, during menstruation and ovulation. They compared the data to women who don’t suffer from migraines and found that CGRP levels were significantly higher in migraine patients.
“This means that when estrogen levels drop immediately before the start of a menstrual period, migraine patients release more CGRP,” says Raffaelli. “This could explain why these patients suffer more migraine attacks just before and during their monthly period.”
Interestingly, since there aren’t many estrogen fluctuations in women who take birth control, CGRP levels stayed relatively even as well. However, these results were consistent in women both with and without migraines. The team noted similar patterns in postmenopausal women as well, which means there may be more pieces to the puzzle.
“The data will still need to be confirmed by larger studies, but our findings do suggest that the release of CGRP depends on hormonal status in humans, as it does in the animal model,” Raffaelli says. “Taking birth control pills and the end of menopause do in fact bring relief for some female migraine patients. But as our study also shows, there are women who suffer from migraine even without any hormonal fluctuations. We suspect that other processes in the body play a role in triggering attacks in those patients. After all, CGRP isn’t the only inflammatory peptide that can cause a migraine attack.”
The findings are published in the journal Neurology.