Egzogeninių ir endogeninių moteriškų lytinių hormonų įtaka moterims, sergančioms migrena

Abstract

Both endogenous and exogenous hormones influence pain patterns of migraine, its nature and intensity, and according to available literature, female sex hormones can have both a harmful and a beneficial effect on vascular comorbidities of migraine. Migraine is a condition in which those who suffer it are already predisposed to the risk of cardiovascular disorders (CVD). Proinflammatory and vasoactive substances released during migraine attacks, make migraineurs susceptive to endothelial damage, thus contributing to the risk of cardiovascular comorbidities. There are independent risk factors that can increase this risk, such as the use of COCs, female sex, a younger age, smoking or arterial hypertension. These are demonstrated to increase the risk of stroke in migraineurs, especially in those with migraine with aura. Endogenous levels of estrogen in females can be beneficial for the vascular endothelium, while exogenous estrogens, as those found in combined hormonal contraception, are mostly contraindicated in those women who suffer from migraine, since they are at a higher risk of suffering from a stroke. On the other hand, progestin-only contraception is indicated for those migraineur women who seek contraceptive methods, as these have not been proven to increase the risk of stroke in these females.

Visi, tiek endogeniniai, tiek ir egzogeniniai hormonai turi įtakos migrenos skausmo pobūdžiui bei intensyvumui, o moters lytiniai hormonai gali turėti tiek neigiamą, tiek teigiamą poveikį migrenos klinikinei išraiškai. Migrenos priepuolių metu išsiskiriančios priešuždegiminės ir vazoaktyvios medžiagos aktyvina endotelio pažeidimus, taip didėja gretutinių širdies ir kraujagyslių ligų rizika. Moterų endogeninis estrogenas dažnai turi teigiamą poveikį kraujagyslių endoteliui, tuo tarpu egzogeniniai estrogenai, pavyzdžiui, gaunami kartu su sudėtinėmis kontraceptinėmis tabletėmis, moterims, sergančioms migrena, nerekomenduojami dėl didesnės insulto rizikos.