• Roberto De Icco, Laura Cucinella, Irene De Paoli, Silvia Martella, Grazia Sances, Vito Bitetto, Giorgio Sandrini, Giuseppe Nappi, Cristina Tassorelli, and Rossella E Nappi.
• Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy. rob.deicco@gmail.com.
• J Headache Pain. 2016 Dec 1; 17 (1): 70.

BackgroundMenstrually-related headache and headaches associated with oestrogen withdrawal are common conditions, whose pathophysiology has not been completely elucidated. In this study we evaluated the influence of combined hormonal contraceptives (CHC) on pain threshold in women presenting migraine attacks during hormone-free interval.FindingsEleven women with migraine attacks recurring exclusively during the oestrogen-withdrawal period were studied with the nociceptive flexion reflex, a neurophysiological assessment of the pain control systems, during the third week of active treatment and during the hormone-free interval. During the hormone-free interval, nociceptive withdrawal reflex threshold was significantly lower (12.8 ± 8.0 mA) as compared to the third week of hormonal treatment (15.6 ± 6.6 mA) (p = 0.02). No change was observed in the pain perceived and in the temporal summation.ConclusionsOestrogen withdrawal may mediate an increased sensitivity to somatosensory stimuli in women with migraine attacks recurring during the hormone-free interval.

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