The 7-day contraceptive hormone-free interval should be consigned to history

Abstract

There is no scientific evidence to support a 7-day CFI and it should be replaced either by a continuous flexible regimen, or extended regimens with a shortened CFI, prescribed first-line. In women preferring a monthly 'bleed', a 4-day CFI similarly provides a greater safety margin when pills are omitted.

Acute and Preventive Management of Migraine during Menstruation and Menopause

“…An alternative strategy to prevent MM in women seeking contraception is to use specific formulations of low-dose estrogens and/or progestins, such as estradiol valerate plus dienogest [80]. Continuous administration of estrogen, without [81] or with a reduced time hormone-free interval [82], or the use of non-oral formulations, such as the vaginal ring [83], also showed efficacy in decreasing the burden of MM (Figure 4). At least 50% reduction in monthly headache days in all treated women; improvement in menstrual symptoms An alternative strategy to prevent MM in women seeking contraception is to use specific formulations of low-dose estrogens and/or progestins, such as estradiol valerate plus dienogest [80].…”

“…At least 50% reduction in monthly headache days in all treated women; improvement in menstrual symptoms An alternative strategy to prevent MM in women seeking contraception is to use specific formulations of low-dose estrogens and/or progestins, such as estradiol valerate plus dienogest [80]. Continuous administration of estrogen, without [81] or with a reduced time hormone-free interval [82], or the use of non-oral formulations, such as the vaginal ring [83], also showed efficacy in decreasing the burden of MM (Figure 4). An alternative modality of hormonal manipulation is the use of phytoestrogen; the daily use of a combination of soy isoflavones, dong quai, and black cohosh, all of which contain phytoestrogens, effectively decreased headache frequency in women with menstrual-related migraine without aura in a randomized controlled trial [84].…”

“…An alternative strategy to prevent MM in women seeking contraception is to use specific formulations of low-dose estrogens and/or progestins, such as estradiol valerate plus dienogest [ 80 ]. Continuous administration of estrogen, without [ 81 ] or with a reduced time hormone-free interval [ 82 ], or the use of non-oral formulations, such as the vaginal ring [ 83 ], also showed efficacy in decreasing the burden of MM ( Figure 4 ).…”

Approaching the appropriate pharmacotherapy of menstrual migraine

“…The most current trend for migraine due to combined oral contraceptives (COCs) withdrawal is to prefer the regimen of the flexible or extended continuous administration of COCs, instead of the 7day contraceptives free interval regimen [14]. In fact, even if pure MM crises related to the suspension of COCs are less intense in severity and disability than the spontaneous ones.…”