Adolescent girls who reach puberty at an earlier age may be at greater risk of developing migraine headaches, according to a new study by the University of Cincinnati (UC) College of Medicine.
“We know that the percentage of girls and boys who have migraine is pretty much the same until menstruation begins,” said Vincent Martin, M.D., professor in the Division of General Internal Medicine and director of the Headache and Facial Pain Center at the UC Gardner Neuroscience Institute.
“When the menstrual period starts in girls, the prevalence goes way up, but what our data suggests is that it occurs even before that.”
Around 10 percent of school age children in the U.S. suffer from migraine, according to the Migraine Research Foundation (MRF). As adolescence approaches, the incidence of migraine increases rapidly in girls, and by age 17, around 23 percent of girls — compared to 8 percent of boys — have experienced migraine.
The 10-year study involved 761 girls from Cincinnati, New York and the San Francisco Bay area. Beginning at age 8 to 10, the girls were examined every six to 12 months during the study period.
Girls answered a headache questionnaire to find out if they suffered from migraine headache, no migraine or probable migraine; the latter is defined as meeting all the diagnostic criteria for migraine except one. The average age at which they completed the survey was 16.
Of those surveyed, 85 girls (11 percent) were diagnosed with migraine headache while 53 (7%) had probable migraine and 623 (82%) had no migraine.
Researchers found that girls with migraine had an earlier age of thelarche (breast development) and the onset of menarche (menstrual periods) than those with no migraine. On average breast development occurred four months earlier in those with migraine while menstruation started five months earlier. There was no difference in the age of pubarche (pubic hair development) between those with migraine and no migraine.
“There was a 25 percent increase in the chance of having migraine for each year earlier that a girl experienced either thelarche or menarche,” said Susan Pinney, Ph.D., professor in the UC Department of Environmental Health and lead investigator on the study. “This suggests a strong relationship between early puberty and the development of migraine in adolescent girls.”
The age of onset of thelarche, pubarche or menarche did not differ between those with probable migraine and no migraine, says Pinney.
Previous studies have shown that migraine often starts with the onset of menstrual cycles during menarche in adolescent girls. But this study looks at earlier stages of puberty such as thelarche and pubarche, said Martin.
“To suggest the origins of migraine may occur actually before menstrual periods begin is pretty novel,” he said. “At each of these stages, different hormones are starting to appear in girls. During pubarche, testosterone and androgens are present, and during thelarche, there is the very first exposure to estrogen.”
“Menarche is when a more mature hormonal pattern emerges. Our study implies that the very first exposure to estrogen could be the starting point for migraine in some adolescent girls. It may be the Big Bang Theory of migraine.”
So is there anything that one can do to prevent an early puberty?
“Studies suggest that childhood obesity is associated with early puberty,” said Martin, who is also president of the National Headache Foundation. “Keeping your weight down might prevent the early onset of puberty. Future studies will need to be done to determine if strategy will decrease also the likelihood of developing migraine.”
Martin recently presented the findings at the American Headache Society’s 61st Annual Scientific Meeting in Philadelphia.
Source: University of Cincinnati