Relevance of Prostaglandins in True Menstrual Migraine

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Abstract
Eighteen patients suffering from true menstrual migraine and 12 control subjects were studed. We evaluated in different phases of the menstrual cycle and during the migraine crisis the peripheral plasma concentrations of 6-keto-PGF1.alpha. (the stable metabolite of PGI2), thromoboxane B2 (the stable metabolite of thromboxane A2), PGF2.alpha. in menstrual migraine suffers are lower than in normal women throughout the whole cycle. The difference between the trends observed in the two groups is statistically significant (p<0.05). The plasma levels of TXB2 and of PGF2.alpha. are similar in the two groups investigated, both in basal conditions and during the attack. The plasma concentrations of PGE2 are slightly lower in migraineurs in basal conditions than in normals. However, during the crisis they increase significantly (p<0.05). In conclusion, among all the parameters considered, PGE2 seems to play the most important role during the pain phase of the attack. The results of the present study suggest that a deficit of PGI2, one of the most important protecting agents against ischemia, might be a typical feature of menstrual migraine and might cause in these patients a vascular hypersensitivity to different ischemic stimuli.