Abstract:As a high incidence and disabling neurological disease in women, menstrual migraine has a long duration and seriously affects the quality of life of patients. Its pathogenesis is closely related to the interaction of neurotransmitters triggered by the fluctuation of estrogen. Previous studies mostly explored the pathogenesis and treatment from a single perspective of estrogen and neurotransmitters, lacking the multi-level interaction and integration of sex hormones and neurotransmitters. This article systematically reviews the periodic mechanisms of estrogen fluctuation in reducing cortical spreading depression, regulating serotonin metabolism, and regulating calcitonin gene-related peptide release, which synergistically activate the trigeminal neurovascular system and mediate neurogenic inflammation and central sensitization. The clinical application and limitations of related drug treatment strategies were further summarized to provide a new perspective for the study of menstrual migraine.
