Prepubertal girls more likely to develop migraine than boys

Puberty brings a host of physiologic changes to both boys and girls, but new research suggests a strong relationship between early puberty and the development of migraine in adolescent girls, according to findings presented at the recent American Headache Society’s 61st Annual Scientific Meeting in Philadelphia, Pennsylvania,

Results of the study “Pubertal maturation and Its association with migraine headache in adolescent girls“ (ID no. OR16) were presented by lead author Vincent Martin, MD, professor, Division of General Internal Medicine, and director, Headache and Facial Pain Center at the University of Cincinnati (UC) Gardner Neuroscience Institute, Cincinnati, Ohio.

Martin and investigators from the UC College of Medicine were involved in a longitudinal study that looked at 761 adolescent girls aged 8 to 20 years from Cincinnati, New York, and San Francisco over 10 years from 2004 to 2014. Girls enrolled in the study at ages 8 to 10 years were examined every 6 to 12 months for initial signs of thelarche (breast development), pubarche (pubic hair), and menarche (start of menstruation). When the girls were aged 16 years, they answered a headache questionnaire about whether they experienced migraine, probable migraine, or no migraine.

Of the girls surveyed, 85 (11%) were diagnosed with migraine headache, 53 (7%) were diagnosed with probable migraine, and 623 (82%) experienced no migraine. The girls diagnosed with migraine had an earlier age of thelarche and onset of menarche than those girls with no migraine. Breast development occurred on average 4 months earlier in those girls with migraine and menstruation began 5 months earlier. There was no difference in pubarche between girls with migraine and those with no migraine.

The researchers noted a 25% increase in having migraine for each year earlier that a girl showed thelarche or menarche, suggesting a strong relationship between early puberty and development of migraine in adolescent girls. There were no differences in thelarche, pubarche, or menarche in girls diagnosed with probable migraine and those with no migraine.

The investigators also said their study implies that first exposure to estrogen might be the starting point for migraine occurrence in some adolescent girls.