I've said this many, many times here and some may be tired of hearing it, BUT I firmly believe that a testosterone imbalance has much to do with CH. Remember too that hormones are regulated by the hypothalamus.

When I got pregnant (7 times), I always jumped right into a cycle, then no headaches until no longer pregnant.  After losing my 4th child, my doctor decided that I needed help due to a hormone imbalance (testosterone), and it worked.  I had NO headaches during my last three pregnancies.

My first symptom of being pregnant was to go into a cluster cycle. Then we started the shots each month and no more CH. I didn't have another CH until I weaned my baby, then back into cycle.  I had to take hormone suppliments each month of my pregnancies in order not to abort.

It's when I had my hysterectomy (uterus and both ovaries) that the cycles ended for good. That's also when I started hormone replacement therapy, which I continued (for 27 years) until just last year.

One of our guys here posted a paper by a research team which indicates that this imbalance DOES effect greater than half of those tested.  

I can't understand why we don't all have a simple test done and rule this possibility out....it may help some or many.  Who knows?  
 

Quote:

I can't understand why we don't all have a simple test done and rule this possibility out....it may help some or many.  Who knows?

Had it done about 2 years ago for something unrelated.....checked out fine.  :-/

B

Thanks for bringing this up again Donna.  I know of at least one Newbie who is checking this out as a result.

Leave no stone unturned  ;)

-Dennis-

Thanks for posting this DonnaH.  I noticed a previous post some time ago and the link that Dennis provided. My Dr. and I are quite interested in this and are investigating it further. Here is my pm that i recently sent Dennis,
[color=#00ff00]Hi Dennis,
I am new to the forum but not new to CH or the treatments available.
I noticed in a recent post that you mentioned and attached a paper on the correlation between low serum testosterone and some cluster headache patients that are particularly resistant to "normal" treatment protocols, and the possible treatment using hormone replacement therapy.
Do you know of anyone that has confirmed the finding and had any experience with this?
I also suffer from Cluster Tic Syndrome (additional neurological fireworks) which further complicates things but in showing your paper today to my Dr. he became quite interested and immediately sent me for a complete bloodworkup including hormone levels etc.

I will not know the results till next week, and i know sexual function is fine, but i also know from some ca stuff i have dealt with in the past that my serum testosterone levels during that period of health trouble was in the low end of the normal range.

Wouldn't it be bizarre if after 30 years i find out that something as simple as a hormone patch could solve my CH!...oh if it could just be so simple....I am still so optimistic that i will find a treatment after all these years when nothing has really worked...(i am one of the unfortunate ones that O2 has no effect). [/color]

In addition, today another member of this forum asked my via pm about my Cluster Tic Syndrome and i was going back thru some of my studies and paperwork and I came across a more recent article that i had found online regarding a condition that horses get called headshaking syndrome which is similar to Cluster tic and in it it compares the similarities to cluster headaches and cluster tic in humans and i quote ( in humans) " The hormonal aspect apears to be related to low levels of testosterone that have been found in males with cluster headaches. the seasonal aspect has been found to be related to melatonin, which is responsible for the entrainment of the biological clock, which has levels that also appear to be low"

Cluster Tic Syndrome patients are known to be the resistant to most drug therapies, and tend to do rather poorly with surgical interventions, so this hormonal imbalance provides an interesting glimpse of optimism. A complete endocrinologicol workup and assessment could take a couple of weeks but i will report back the findings....as stated in my pm, the reason i am somewhat optimistic is that some years back i was dealing with ca and at that time my serum test was on the low side of the normal range...
paul

Donna, this is gaining recognition, and you're right - it's a simple blood test.

The "original" study I think you're referring to is this one:  START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

There are others:  
START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

And this:

The Autonomic Nervous System, by By Otto Appenzeller, P. J. Vinken, G. W. Bruyn:  START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

"The prevalence of cluster headache in males, and the fact that it is extremely rare in the pre-adolescent period, indicates that sex hormones might also be involved in the pathogenetic mechanism.  Testosterone levels have been reported to be normal or low during the cluster headache period (Leone and Bussoni 1993).  Total, free and carrier protein-bound testosterone levels were significantly diminished only in chronic cluster headache patients whose basal and peak FSH levels were significantly increased (Murialdo et al. 1989).  In addtion, a significant reduction of the 24-h integrated mean testosterone level (mesor) and in acrophase delay were found in cluster headache patients.  It was suggested that the stress of the attack caused elevated cortisol levels tand that this, in turn, would reduce testosterone levels (Facchinetti et al. 1986)."


There is an intricate connection between all the chemicals that are being identified as having a role in cluster headaches, especially as regards serotonin, melatonin and testosterone.  Makes sense given the role of the hypothalamus in controlling brain functions related to all of these things.

A very interesting read:  "Melatonin Keeps the Timing Right," by Abraham Kryger, MD, DMD.  It discusses the relationship between melatonin, serotonin, testosterone and other issues of the endocrine system: START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Laurie

The first page is all that is available for free, but here is an article by Dr. Goadsby, "Evidence for Hypothalamic Activation in Cluster Headache,"  (PDF):  START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE  (From START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE)

Though interestingly, I found a discussion where it seems the low testosterone level is a result of the pain, not hypothalamic activity, as it appears also in cases of trigeminal neuralgia and radicular pain:

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Laurie

Headache. 2006 Jun;46(6):925-33.  


Testosterone replacement therapy for treatment refractory cluster headache.

Stillman MJ.

Objectives.-To describe the clinical characteristics and laboratory findings of cluster headache patients whose headaches responded to testosterone replacement therapy. Background.-Current evidence points to hypothalamic dysfunction, with increased metabolic hyperactivity in the region of the suprachiasmatic nucleus, as being important in the genesis of cluster headaches. This is clinically borne out in the circadian and diurnal behavior of these headaches. For years it has been recognized that male cluster headache patients appear overmasculinized. Recent neuroendocrine and sleep studies now point to an association between gonadotropin and corticotropin levels and hypothalamically entrained pineal secretion of melatonin. Results.-Seven male and 2 female patients, seen between July 2004 and February 2005, and between the ages of 32 and 56, are reported with histories of treatment resistant cluster headaches accompanied by borderline low or low serum testosterone levels. The patients failed to respond to individually tailored medical regimens, including melatonin doses of 12 mg a day or higher, high flow oxygen, maximally tolerated verapamil, antiepileptic agents, and parenteral serotonin agonists. Seven of the 9 patients met 2004 International Classification for the Diagnosis of Headache criteria for chronic cluster headaches; the other 2 patients had episodic cluster headaches of several months duration. After neurological and physical examination all patients had laboratory investigations including fasting lipid panel, PSA (where indicated), LH, FSH, and testosterone levels (both free and total). All 9 patients demonstrated either abnormally low or low, normal testosterone levels. After supplementation with either pure testosterone in 5 of 7 male patients or combination testosterone/estrogen therapy in both female patients, the patients achieved cluster headache freedom for the first 24 hours. Four male chronic cluster patients, all with abnormally low testosterone levels, achieved remission. Conclusions.-Abnormal testosterone levels in patients with episodic or chronic cluster headaches refractory to maximal medical management may predict a therapeutic response to testosterone replacement therapy. In the described cases, diurnal variation of attacks, a seasonal cluster pattern, and previous, transient responsiveness to melatonin therapy pointed to the hypothalamus as the site of neurological dysfunction. Prospective studies pairing hormone levels and polysomnographic data are needed.

PMID: 16732838