Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?

Rossella E. Nappi, Gabriele S. Merki-Feld, Erica Terreno, Alice Pellegrinelli, Michele Viana

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75μg has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies.

Original languageEnglish
Pages (from-to)66
Number of pages1
JournalJournal of Headache and Pain
Volume14
DOIs
Publication statusPublished - 2013

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Progestins
Migraine Disorders
Contraception
Migraine with Aura
Stroke
Desogestrel
Migraine without Aura
Thrombophilia
Venous Thromboembolism
Contraceptive Agents
Ovulation
Hyperlipidemias
Blood Vessels
Headache
Analgesics
Estrogens
Smoking
Maintenance
Guidelines
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hormonal contraception in women with migraine : is progestogen-only contraception a better choice? / Nappi, Rossella E.; Merki-Feld, Gabriele S.; Terreno, Erica; Pellegrinelli, Alice; Viana, Michele.

In: Journal of Headache and Pain, Vol. 14, 2013, p. 66.

Research output: Contribution to journalArticle

Nappi, Rossella E. ; Merki-Feld, Gabriele S. ; Terreno, Erica ; Pellegrinelli, Alice ; Viana, Michele. / Hormonal contraception in women with migraine : is progestogen-only contraception a better choice?. In: Journal of Headache and Pain. 2013 ; Vol. 14. pp. 66.
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