Hormonas y migraña, una aproximación clínica
Hormones and migraine, a clinical approach
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La migraña es la cefalea primaria más frecuente en las mujeres y si se suman las diversas fluctuaciones hormonales en el transcurso de la vida, la prevalencia es hasta tres veces más que en los hombres. Varía según la edad sexual siendo muchas veces la menarquia el inicio de la misma, así como la presentación exclusiva o facilitada por el período menstrual, la posmenopausia o el verdadero reto, el embarazo. Cuando mujeres de diferentes edades y tipos de cefalea, consultan, es la experticia y la adecuada orientación clínica inicial las que pueden lograr un diagnóstico oportuno y acertado. La migraña es un dolor de cabeza en los servicios de urgencias, no solo por la complejidad de su manejo en las pacientes gestantes, sino por las pocas opciones terapéuticas disponibles que sean seguras más para el feto que para la madre. El médico se ve obligado a tomar decisiones terapéuticas acertadas, generando mejoría del cuadro clínico y confianza en su paciente. Abordamos entonces el dolor de cabeza migrañoso en las mujeres durante las diversas edades en que la fluctuación de hormonas sexuales genera este trastorno, desde los puntos de vista fisiopatológico, enfoque diagnóstico y principales opciones terapéuticas estudiadas hasta el momento. Abreviaturas: MG, migraña (s); ACV, accidente cerebrovascular.
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