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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Oral Contraceptives Linked to
Perimenstrual Migraine |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(ECCC)— The use of oral contraceptives appears to
have a strong influence on the frequency and severity of
perimenstrual migraine, according to data reported on April 17
at the annual meeting of American Academy of Neurology.
Women using hormonal contraceptives have a three- to fourfold
greater incidence of migraine and more moderate-to-severe
migraines during the perimenstrual period compared with other
days of the month, said John Campbell, associate director of
medical affairs at Endo Pharmaceuticals, Inc., in Chadds Ford,
Pa.
“Our principal goal was to define the frequency of migraine
across the spectrum of the menstrual cycle in women with
difficult-to-treat menstrual migraine,” said Campbell. “However,
the association with hormonal contraception came as a surprise.
Future studies of menstrual migraine definitely should examine
the association between use of hormonal contraceptives and the
occurrence of migraine during the perimenstrual period.”
The findings came from data from the placebo group of a
randomized clinical trial of prophylactic therapy for
difficult-to-treat menstrual migraine. The analysis focused on
the frequency and severity of migraine in the perimenstrual
period—defined as two days before the start of menstruation (-2)
to the third day of menstruation (+3).
The placebo group of the clinical trial was made up of 161 women
who had an average of 2.9 menstrual migraine episodes in the 3
months before enrollment in the study. Of those, 154 had
evaluable headache diaries used to document the occurrence and
characteristics of headaches they experienced during the trial.
After excluding the patients who had pure menstrual migraine
(headache occurring outside the range of the perimenstrual
period), the investigators evaluated 135 patients, 46 who used
hormonal contraceptives and 89 who did not.
In comparison with migraine outside the perimenstrual period,
contraceptive users had a 4.5-fold increased frequency of
migraine on day +1 and a 3.6-fold increased frequency on day +3.
Additionally, moderate-to-severe migraine episodes were 4.1
times more common on day +1 and 2.7 times more likely on day +3.
In contrast, migraine frequency or severity did not differ
between the perimenstrual period and days outside the period in
women who were not taking hormonal contraceptives.
The study was not designed to determine whether migraine
frequency or severity varied among different types of hormonal
contraceptives, said Campbell. That issue should be evaluated in
future studies. Any association between menstrual migraine and
specific contraceptives would suggest that switching
contraceptives might have an effect on migraine frequency and
severity. |
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