Review: Significance of hormonal changes in migraine and cluster headache

Abstract

Introduction Headache is commonly considered a prevailing feature of the female condition. It is not a chance that headache is often regarded as one of the main factors making females occasionally unable to do something, not only in fiction but also in reality. On the other hand, besides anecdotal considerations, epidemiological data highlight hormonal changes among the major factors in headache. Hormones and brain are mutually strictly related so as to be considered a unique functional entity, namely, the neuroendocrine system. In fact, hormones are influenced by the central nervous system (CNS), while they also exert several different actions on the brain'. The key structure where most of these influences occur is the hypothalamus. Here the vegetative, emotional and temporal functions essential for living and being, both in the environment and time, are integrated and transduced into order signals that the endocrine system can execute. Most activities or diseases of the endocrine gland are not relevant to primary (idiopathic) headaches. Glands as pituitary, thyroid, adrenal or pancreas can be involved in the factors triggering headache attacks and can participate in the behavioural reactions connected with head pain. However, in most instances they are co-workers rather than protagonists.