Modulation of nociceptive threshold by combined hormonal contraceptives in women with oestrogen-withdrawal migraine attacks: a pilot study

Roberto De Icco, Laura Cucinella, Irene De Paoli, Silvia Martella, Grazia Sances, Vito Bitetto, Giorgio Sandrini, Giuseppe Nappi, Cristina Tassorelli, Rossella E. Nappi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Menstrually-related headache and headaches associated with oestrogen withdrawal are common conditions, whose pathophysiology has not been completely elucidated. In this study we evaluated the influence of combined hormonal contraceptives (CHC) on pain threshold in women presenting migraine attacks during hormone-free interval. Findings: Eleven women with migraine attacks recurring exclusively during the oestrogen-withdrawal period were studied with the nociceptive flexion reflex, a neurophysiological assessment of the pain control systems, during the third week of active treatment and during the hormone-free interval. During the hormone-free interval, nociceptive withdrawal reflex threshold was significantly lower (12.8 ± 8.0 mA) as compared to the third week of hormonal treatment (15.6 ± 6.6 mA) (p = 0.02). No change was observed in the pain perceived and in the temporal summation. Conclusions: Oestrogen withdrawal may mediate an increased sensitivity to somatosensory stimuli in women with migraine attacks recurring during the hormone-free interval.

Original languageEnglish
Article number70
JournalJournal of Headache and Pain
Volume17
Issue number1
DOIs
Publication statusPublished - Dec 1 2016

Keywords

  • Combined hormonal contraceptives
  • Menstrually related migraine
  • Nociceptive withdrawal reflex
  • Oestrogen withdrawal headache

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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