The Impact of Extended‐Cycle Vaginal Ring Contraception on Migraine Aura: A Retrospective Case Series

Abstract

In this sample of women with both MwA and MRM, use of an extended-cycle vaginal ring contraceptive was associated with a reduced frequency of migraine aura and with resolution of MRM. This cannot be extrapolated to suggest that stroke risk in MwA will be similarly reduced. Studies to evaluate this relationship are warranted.

Progestin-only contraception compared with extended combined oral contraceptive in women with migraine without aura: a retrospective pilot study

“…The use of a cyclic versus an extended progestin/ethinyl estradiol patch, the use of a 168-day extended COC regimen or the use of 24 + 4 days COC instead of a 21 + 7 days formulation seemed to reduce the total incidence of headache days compared with a 21/ 7-day regimen [4][5][6][7]. The good results obtained in these studies (decrease in migraine pattern when extended cycles were tested) led to the use of this formulation in this population.…”

“…As hormonal fluctuations are thought to likely play a role in migraine pathophysiology, and estrogen withdrawal is probably one of the more important triggers, several studies have tried to optimize hormonal treatment in women with migraine without aura (MO) who desire hormonal contraception [4][5][6][7]. The rationale of these studies was to eliminate or minimize premenstrual estrogen withdrawal and thus maintain steady estrogen levels [8].…”

Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH)

“…In 11 studies treatment was specifically used for headache prevention [12, 29–38], in 8 studies treatment effect on headache was evaluated in women who required treatment for contraception or medical reasons [13–15, 39–43], in 2 studies it was not specifically stated if treatment was prescribed specifically for headache treatment or for other indications [44, 45]. Five studies were performed in women with MO or MA not necessarily related to menstruation [12–14, 41, 43], 10 in MRM or MM [29–39, 43, 45], 4 in PMM [29, 35, 38, 39], and 2 in women with and without headache [15, 40].…”

Practice Guideline: Contraception for Adolescents with Chronic Illness

“…A recent study investigated the use of exogenous estrogen use in patients diagnosed as having migraine with aura and found a significant reduction in both migraines and auras (Calhoun, Ford, & Pruitt, 2012). This could confer a lower risk of stroke compared with migraineurs who do not use hormonal contraceptives.…”