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Quality in Sport

One Axis, Two Faces: The Shared Biology of PMS and Migraine
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One Axis, Two Faces: The Shared Biology of PMS and Migraine

Authors

  • Michalina Makieła Wolski Hospital Dr. Anna Gostyńska, Marcina Kasprzaka 17, 01-211 Warsaw, Poland
 https://orcid.org/0009-0003-4465-8584
  • Weronika Koziak Wolski Hospital Dr. Anna Gostyńska, Marcina Kasprzaka 17, 01-211 Warsaw, Poland https://orcid.org/0009-0003-5295-5765
  • Marta Makieła Spitalzentrum Oberwallis (Visp), Pflanzettastrasse 8, 3930 Visp, Switzerland https://orcid.org/0009-0005-7199-385X
  • Aleksandra Bętkowska National Medical Institute of the Ministry of the Interior and Administration https://orcid.org/0009-0001-5108-4262
  • Agata Kornacka University Clinical Center of the Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland https://orcid.org/0009-0007-2877-3514
  • Aleksandra Zając University Clinical Hospital in Poznań, ul. Przybyszewskiego 49, 60-355 Poznań, Poland https://orcid.org/0009-0000-9522-5779
  • Kamila Szostak The Infant Jesus Teaching Hospital, Lindleya 4, 02-005 Warszawa https://orcid.org/0009-0005-6216-0864
  • Rafał Tomaka University Clinical Center of the Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland https://orcid.org/0009-0002-5057-6131
  • Daniel Worobiej Wolski Hospital Dr. Anna Gostyńska, Marcina Kasprzaka 17, 01-211 Warsaw, Poland https://orcid.org/0009-0002-1153-9821
  • Stanisław Dudek University Clinical Center of the Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland https://orcid.org/0009-0002-3641-4865

DOI:

https://doi.org/10.12775/QS.2025.41.60065

Keywords

Hormonal Fluctuations, Estrogen Withdrawal, Neurotransmitter Dysregulation, Premenstrual Syndrome (PMS), Migraine Pathophysiology, Neuroendocrine Axis

Abstract

Premenstrual Syndrome (PMS) and migraine are two clinically distinct but biologically intertwined conditions that disproportionately affect individuals of reproductive age. Both disorders are characterized by cyclical patterns tied to hormonal fluctuations—most notably the abrupt withdrawal of estrogen and changes in progesterone levels during the luteal phase. Recent research reveals a convergence of underlying mechanisms, including dysregulation of the serotonergic and GABAergic systems, neurovascular instability, and heightened inflammatory responses. This narrative review explores how a shared neuroendocrine axis may drive the manifestation of both PMS and migraine, resulting in overlapping physical and emotional symptoms. By examining these interconnected pathways, we aim to illuminate opportunities for integrated diagnostic strategies and multimodal therapeutic approaches that consider the full scope of hormonal, neurological, and immune interactions. Understanding the "one axis, two faces" framework could be the key to more effective and individualized care.

References

Freeman, E. W., Rickels, K., Arredondo, F., Kao, L. C., Pollack, S. E., & Sondheimer, S. J. (1999). Full- or half-cycle treatment of severe premenstrual syndrome with a serotonergic antidepressant. Journal of Clinical Psychopharmacology, 19(1), 3–8.

Kroeze, W. K., & Roth, B. L. (1998). The molecular biology of serotonin receptors: Therapeutic implications for the interface of mood and psychosis. Biological Psychiatry, 44(11), 1128–1142. PMID: 9836016

Halbreich, U. (2003). The association between hormones and depression in women. Journal of Affective Disorders, 74(1), 1–9.

Girdler, S. S., & Klatzkin, R. (2007). Biological mechanisms underlying the relationship between PMS and stress: Preliminary data. Current Psychiatry Reports, 9(6), 467–475.

Peroutka, S. J. (1997). Dopamine and migraine. Neurology, 49(3), 650–656.

Rapkin, A. J., & Lewis, E. I. (2013). Treatment of premenstrual dysphoric disorder. Women's Health (London), 9(6), 537–556.

Epperson, C. N., Haga, K., Mason, G. F., et al. (2002). Cortical γ-aminobutyric acid levels across the menstrual cycle in healthy women and those with PMDD. The Journal of Clinical Endocrinology & Metabolism, 87(12), 5556–5560.

Calhoun, A. H., & Hutchinson, S. (2009). Hormonal therapies for menstrual migraine. Current Pain and Headache Reports, 13(5), 381–385.

Nappi, R. E., Sances, G., & Facchinetti, F. (2013). Hormonal aspects of migraine and their therapeutic implications. Expert Review of Neurotherapeutics, 13(4), 421–432.

MacGregor, E. A. (2014). Estrogen and attacks of migraine with and without aura. The Lancet Neurology, 13(4), 303–313.

Facchinetti, F., Sances, G., Borella, P., Genazzani, A. R., & Nappi, G. (2003). Magnesium prophylaxis of menstrual migraine: Effects on intracellular magnesium. Headache: The Journal of Head and Face Pain, 43(7), 596–602.

Schiavone, S., Jaquet, V., Trabace, L., & Krause, K. H. (2015). Severe life stress and oxidative stress in the brain: From animal models to human pathology. Antioxidants & Redox Signaling, 23(11), 1080–1091.

Yonkers, K. A., O'Brien, P. M. S., & Eriksson, E. (2008). Premenstrual syndrome. The Lancet, 371(9619), 1200–1210.

Vetvik, K. G., & MacGregor, E. A. (2017). Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. The Lancet Neurology, 16(1), 76–87.

MacGregor, E. A. (2004). Oestrogen and attacks of migraine with and without aura. The Lancet Neurology, 3(6), 354–361.

Halbreich, U., & Kahn, L. S. (2001). Role of estrogen in the aetiology and treatment of mood disorders. CNS Drugs, 15(10), 797–817.

Epperson, C. N., Haga, K., Mason, G. F., et al. (2002). Cortical γ-aminobutyric acid levels across the menstrual cycle in healthy women and those with PMDD. The Journal of Clinical Endocrinology & Metabolism, 87(12), 5556–5560.

Ashkenazi, A., & Silberstein, S. D. (2006). Hormone-related headache: Pathophysiology and treatment. CNS Drugs, 20(2), 125–141. PMID: 16478288

Pearlstein, T., & Steiner, M. (2008). Premenstrual dysphoric disorder: Burden of illness and treatment update. Journal of Psychiatry & Neuroscience, 33(4), 291–301.

Benedetti, F., et al. (2015). Serotonin and mood disorders: From cell biology to psychopharmacology. Neuropharmacology, 95, 5–16.

Edvinsson, L., & Uddman, R. (2005). Neurobiology in primary headaches. Brain Research Reviews, 48(3), 438–456.

Russo, A. F. (2015). Calcitonin gene-related peptide (CGRP): A new target for migraine. Annual Review of Pharmacology and Toxicology, 55, 533–552.

Maizels, M., & Burchette, R. (2004). Somatic symptoms in headache patients: Influence of migraine and depression. Headache, 44(9), 974–982.

Pietrobon, D., & Moskowitz, M. A. (2013). Pathophysiology of migraine. Annual Review of Physiology, 75, 365–391.

Finocchi, C., & Sassos, D. (2012). Headache and hormones: Migraine and menopause. Neurological Sciences, 33(Suppl 1), S47–S50.

Mateen, S., Zafar, A., Moin, S., Khan, A. Q., & Zubair, S. (2016). Understanding the role of cytokines in the pathogenesis of rheumatoid arthritis. Clinica Chimica Acta, 455, 161–171.

Graziottin, A., & Gambini, D. (2006). The role of inflammation in endometriosis. Gynecological Endocrinology, 22(9), 556–562.

Dodick, D. W. (2018). A phase-by-phase review of migraine pathophysiology. Headache, 58(Suppl 1), 4–16.

Bigal, M. E., Rapoport, A. M., Lipton, R. B., Tepper, S. J., & Sheftell, F. D. (2008). Assessment of migraine disability using the MIDAS questionnaire. Headache, 43(10), 1089–1095.

Fuh, J. L., Wang, S. J., Lu, S. R., & Juang, K. D. (2007). Comorbid migraine, major depression, and anxiety disorders in adolescents. Neurology, 68(6), 419–424.

Pavlović, J. M., Buse, D. C., & Lipton, R. B. (2015). Association of migraine with reproductive hormones and contraceptive use in women. Current Pain and Headache Reports, 19(10), 47.

Girdler, S. S., & Klatzkin, R. (2007). Biological mechanisms underlying the relationship between PMS and stress: preliminary data. Current Psychiatry Reports, 9(6), 467–475.

Silberstein, S. D., & Merriam, G. R. (1991). Estrogens, progestins, and headache. Neurology, 41(6), 786–793.

Charles, A. (2018). The pathophysiology of migraine: Implications for clinical management. The Lancet Neurology, 17(2), 174–182.

Rapkin, A. J., & Akopians, A. L. (2012). Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder. Menopause International, 18(2), 52–59.

Pavlović, J. M., et al. (2015). Menstrual migraine: What we know and what we need to know. Current Pain and Headache Reports, 19(3), 19.

Sances, G., et al. (2004). Estrogen levels and migraine in women with menstrual-related migraine: A pilot study. Headache, 44(9), 930–934.

Holroyd, K. A., et al. (2010). Cognitive-behavioral therapy and preventive drug treatment for chronic migraine. Headache, 50(4), 600–613.

Rains, J. C., et al. (2005). Behavioral sleep medicine for chronic headache: A randomized controlled trial. Headache, 45(5), 512–522.

Nappi, R. E., et al. (2013). Hormonal aspects of migraine and their therapeutic implications. Expert Review of Neurotherapeutics, 13(4), 423–435.

Genazzani, A. R., et al. (2010). Neurosteroids and neuroprotection: A major challenge in neuroendocrinology. Frontiers in Neuroendocrinology, 31(3), 287–302.

Bigal, M. E., & Lipton, R. B. (2006). Modifiable risk factors for migraine progression. Headache: The Journal of Head and Face Pain, 46(9), 1334–1343.

Pearlstein, T. B., & Steiner, M. (2008). Premenstrual dysphoric disorder: Burden of illness and treatment updates. Journal of Psychiatry & Neuroscience, 33(4), 291–301.

Calhoun, A. H. (2012). Menstrual migraine: Update on pathophysiology and approach to therapy and management. Current Treatment Options in Neurology, 14(1), 1–14.

Bigal, M. E., & Lipton, R. B. (2006). Concepts and mechanisms of migraine chronification. Headache: The Journal of Head and Face Pain, 46(Suppl 4), S9–S15.

Sances, G., Granella, F., Nappi, R. E., Ghiotto, N., Polatti, F., & Nappi, G. (2004). Course of migraine during pregnancy and postpartum: A prospective study. Cephalalgia, 24(2), 142–149.

Nappi, R. E., Berga, S. L., Luisi, S., & Koenen, C. (2013). Hormonal management of migraines in women: An update. European Journal of Neurology, 20(5), 685–692.

Genazzani, A. R., Gadducci, A., Gambacciani, M., & Simoncini, T. (2010). Hormonal therapies in postmenopausal women and effects on central nervous system, cardiovascular system, and cancer risk. Gynecological Endocrinology, 26(11), 791–807.

Holroyd, K. A., Lipchik, G. L., & Penzien, D. B. (2010). Behavioral management of recurrent headache: Three decades of experience and empiricism. Applied Psychophysiology and Biofeedback, 35(2), 137–151.

Rains, J. C., Penzien, D. B., McCrory, D. C., & Gray, R. N. (2005). Behavioral facilitation of medical treatment for headache—part I: Review of headache treatment compliance. Headache: The Journal of Head and Face Pain, 45(10), 1337–1343.

Charles, A. (2018). The pathophysiology of migraine: Implications for clinical management. The Lancet Neurology, 17(2), 174–182.

MacGregor, E. A. (2015). Menstrual migraine: A clinical update. Cephalalgia, 35(10), 896–905.

American College of Obstetricians and Gynecologists (ACOG). (2015). Premenstrual syndrome (PMS). ACOG Practice Bulletin.

Freedman, F. (2014). Menstrual migraine: Pathophysiology, diagnosis, and treatment. Practical Neurology, 14(2), 111–118.

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Published

2025-05-11

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1.
MAKIEŁA, Michalina, KOZIAK, Weronika, MAKIEŁA, Marta, BĘTKOWSKA, Aleksandra, KORNACKA, Agata, ZAJĄC, Aleksandra, SZOSTAK, Kamila, TOMAKA, Rafał, WOROBIEJ, Daniel and DUDEK, Stanisław. One Axis, Two Faces: The Shared Biology of PMS and Migraine. Quality in Sport. Online. 11 May 2025. Vol. 41, p. 60065. [Accessed 28 June 2025]. DOI 10.12775/QS.2025.41.60065.
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Vol. 41 (2025)

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Copyright (c) 2025 Michalina Makieła, Weronika Koziak, Marta Makieła, Aleksandra Bętkowska, Agata Kornacka, Aleksandra Zając, Kamila Szostak, Rafał Tomaka, Daniel Worobiej, Stanisław Dudek

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Hormonal Fluctuations, Estrogen Withdrawal, Neurotransmitter Dysregulation, Premenstrual Syndrome (PMS), Migraine Pathophysiology, Neuroendocrine Axis
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