Allostatic Load in Perimenopausal Women With Migraine.

Pamela Alebna,Nasim Maleki

doi:10.3389/fneur.2021.649423

Pamela Alebna, Nasim Maleki

Open Access

https://doi.org/10.3389/fneur.2021.649423

Copy DOI

Abstract

Objective: There is very limited data on women with migraine disease as they age and transition to menopause. Despite evidence for the increased burden of the disease during this transition, there is no data on the association between migraine and allostatic load as a marker of cumulative biological risk. We aimed to determine whether women with migraine suffer from higher levels of allostatic load during perimenopausal transition.Methods: A total of 2,105 perimenopausal women from the first wave of the Study of Women's Health Across the Nation (SWAN) were included in this study. Allostatic Load (AL) score was estimated for each participant from the measurements of: systolic and diastolic blood pressure, C-reactive protein level, high-density lipoprotein cholesterol level, total cholesterol level, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone levels.Results: Of the 2,105 participants included in the study, there were 369 migraineurs and 1,730 controls. Migraineurs had 63% higher odds of increased load score (odds ratio 1.63; 95% confidence interval, 1.17–2.29). Compared to controls, migraineurs were more likely to experience sleep problems in the univariate analysis, however despite the high burden of sleep problems, there were no significant associations between allostatic load and sleep disturbances in perimenopausal women with migraine after controlling for other factors.Conclusion: This is the first study to systematically and quantitatively examine allostatic load in migraine patients. The findings establish that migraineurs are more likely to experience higher allostatic load than their non-migraine counterparts during perimenopausal transition. The findings encourage new lines of investigation for lowering the burden of the disease through interventions that modify the levels of allostatic load biomarkers examined in this study.

Highlights

Migraine is a chronic and debilitating primary headache disorder with global prevalence of 18.9% for women and 9.8% for men [1]
Menopausal transition is a prolonged period of strong hormonal fluctuations with the risk of chronic headaches increased by almost 60% in migraineurs [5]
With regards to menopausal status most of our migraineurs (95.60%) and controls (93.91%) were premenopausal and early premenopausal mainly because we looked at the first cohort of the study at which time most participants had not transitioned to menopause

Summary

Introduction

Migraine is a chronic and debilitating primary headache disorder with global prevalence of 18.9% for women and 9.8% for men [1]. Menopausal transition is a prolonged period of strong hormonal fluctuations with the risk of chronic headaches increased by almost 60% in migraineurs [5]. Allostatic load (AL), as an assessment of the body’s physiological response to stress, both chronic and acute, is commonly described as a measure of the “wear and tear” the human body goes through in the face of internal and external stressors. The chronic stress model of allostatic load suggests that, when the body is subject to stressors for varying lengths of time, its compensatory mechanisms kick in to maintain homeostasis If this persists, it results in a dysregulation of biological systems which can be estimated by measuring certain biomarkers [7,8,9]

Methods

Results

Discussion

Conclusion