Case reports: Could sexual dysfunction in women with migraine be a side effect of CGRP inhibition?

Cephalalgia. 2024 May;44(5):3331024241248837. doi: 10.1177/03331024241248837.

Abstract

Background: The development and approval of antibodies targeting calcitonin gene-related peptide or its receptor mark a revolutionary era for preventive migraine treatment. Real-world evidence sheds light on rare, stigmatized or overlooked side effects of these drugs. One of these potential side effects is sexual dysfunction.

Case reports: We present two cases of one 42-year-old and one 45-year-old female patient with chronic migraine who both reported sexual dysfunction as a possible side effect of treatment with galcanezumab, a monoclonal antibody targeting calcitonin gene-related peptide.

Discussion: As calcitonin gene-related peptide is involved in vaginal lubrication as well as genital sensation and swelling, inhibiting the calcitonin gene-related peptide pathway may lead to sexual dysfunction as a potential side effect.

Conclusion: Sexual dysfunction in female migraine patients might be a rare and overlooked side effect of monoclonal antibodies targeting the calcitonin gene-related peptide pathway. Considering the discomfort and stigma surrounding both migraine and sexual dysfunction, we advocate for an open attitude and awareness among clinicians toward such side effects.

Keywords: CGRP inhibition; Case report; adverse event; galcanezumab; migraine; sexual dysfunction; side effect; women.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Calcitonin Gene-Related Peptide Receptor Antagonists / adverse effects
  • Calcitonin Gene-Related Peptide Receptor Antagonists / therapeutic use
  • Calcitonin Gene-Related Peptide* / antagonists & inhibitors
  • Female
  • Humans
  • Middle Aged
  • Migraine Disorders* / drug therapy
  • Sexual Dysfunction, Physiological* / chemically induced

Substances

  • Calcitonin Gene-Related Peptide
  • galcanezumab
  • Antibodies, Monoclonal, Humanized
  • Calcitonin Gene-Related Peptide Receptor Antagonists
  • Antibodies, Monoclonal