Hormonal therapies for menstrual migraine

Calhoun, Anne H.; Hutchinson, Susan

doi:10.1007/s11916-009-0062-5

Cited by 15 publications

(13 citation statements)

References 20 publications

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“…Lybrel is designed to be taken continuously 365 days in a year, with no placebo, and may be particularly effective for women who develop migraines or premenstrual syndrome during the placebo week. 28 Standard monophasic OCPs have been used off-label in an extended or continuous regimen by skipping the placebo week or with the addition of oral or transdermal estradiol during the placebo week. There is a lack of long-term safety data for all extended cycle-combined contraceptives.…”

Section: Estrogen-containing Contraceptivesmentioning

confidence: 99%

Pharmacological therapy for abnormal uterine bleeding

Pinkerton

2011

Menopause

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Pharmacological therapies for the treatment of abnormal uterine bleeding are effective and generally well tolerated. This review presents an evidence-based approach to medical therapy. Selection depends on the etiology and amount of bleeding, need for contraception or preservation of fertility, perimenopause status, and medication efficacy and adverse effects.Available nonhormonal agents include nonsteroidal anti-inflammatory agents, which reduce bleeding by 25% to 35% and improve dysmenorrhea through reduced prostaglandin levels; tranexamic acid, which inhibits plasminogen activator with a 40% to 60% reduction in menstrual blood loss; and intranasal desmopressin, which is an antifibrinolytic for women with an underlying bleeding disorder (eg, von Willebrand disease).Hormonal regimens cause the inhibition of endometrial growth. Cyclic progestogen therapy for 21 days results in a significant reduction in menstrual blood loss. Limited data suggest that oral contraceptives reduce menstrual blood loss by 40% to 50% with decreased breast tenderness and dysmenorrhea and a reduction in risk of uterine and ovarian cancer. The progestin-releasing intrauterine devices are effective up to 97% by 6 months and provide relief of dysmenorrhea and contraception. Long-acting progestogen injections produce amenorrhea and provide contraception but are associated with irregular spotting and reversible bone loss. Danazol leads to endometrial atrophy with a reduced menstrual loss; androgenic adverse effects may be lessened with lower doses or vaginal use. Gonadotrophin agonists lead to ovarian suppression and are used to shrink fibroids or the endometrium preoperatively but are limited by hypoestrogenic adverse events. Emergency use of parenteral conjugated estrogens has a 70% chance of stopping abnormal bleeding but an increased risk of thrombosis.

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Section: Estrogen-containing Contraceptivesmentioning

confidence: 99%

Pharmacological therapy for abnormal uterine bleeding

Pinkerton

2011

Menopause

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“…Hormonal treatments are not proven to be safer or more effective than nonhormonal strategies for menstrual migraine. However, it makes sense to target the presumed trigger for hormonally associated headaches, particularly when nonhormonal strategies have been unsuccessful [6,18].…”

Section: Menstrual Migraine In Women Not Taking Hormonal Contraceptivesmentioning

confidence: 99%

“…Extending the cycle of active hormone administration with ECHCs, reducing the hormone-free interval, or supplementing estrogen during the hormone-free interval each appear to be appropriate strategies to reduce the risk of estrogen-withdrawal headaches for women who are using hormonal contraceptives [18,25,26].…”

Section: Hormonal Contraception-related Headachesmentioning

confidence: 99%

“…A selected list of transdermal estradiol products, with typical doses used for this purpose, include the following: Climara (Schering AG, Berlin, Germany; 0.075-, 0.1-mg patch) administered once weekly, Vivelle-Dot (Novartis Pharmaceuticals, Basel, Switzerland; 0.075-, 0.1-mg patch) twice weekly; alternatively Divigel (Upsher-Smith Laboratories, Maple Grove, MN; 1-g gel/packet) once daily, Estrasorb (Graceway Pharmaceuticals, Bristol, TN; 1.74-g emulsion/ packet, 1-2 packets) daily, or EstroGel (Ascend Therapeutics, Herndon, VA; 1.25-g gel/metered pump) once daily. In summary, current options for managing hormonal contraceptive-associated headache are listed in Table 4 [18,25].…”

Section: Hormonal Contraception-related Headachesmentioning

confidence: 99%

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Hormonal Manipulation Strategies in the Management of Menstrual Migraine and Other Hormonally Related Headaches

Shuster

Faubion

Sood

et al. 2011

Curr Neurol Neurosci Rep

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Menstrual migraine and other hormonally related headaches are common in women. Falling estrogen levels or estrogen withdrawal after periods of sustained higher levels can trigger migraine. It makes sense to target this trigger for management of hormonally related headaches, particularly when nonhormonal strategies have been unsuccessful. Decision making regarding the use of hormonal contraception and menopausal hormone therapy is complex and commonly driven by other factors, but hormonal manipulation can potentially improve the course of migraine. Providers caring for migraineurs are appropriately concerned about stroke risk. Estrogen-containing hormonal contraceptives are relatively contraindicated for women who have migraine with aura. Postmenopausal hormone therapy is acceptable for women with a history of migraine. For these women, transdermal estradiol is recommended. Estrogen replacement is important for women who undergo an early menopause, whether natural or induced. Practical strategies for hormonal manipulation in the management of migraine and other hormonally related headaches are presented.

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“…In addition some of them can suffer gynecological conditions that are comorbid with migraine (such as endometriosis) that can be treated with combined hormonal contraception (CHC). This enhances the likelihood of CHC use in the migrainous population [2,3].…”

Section: Introductionmentioning

confidence: 99%