BACKGROUND: Migraine with aura (MA) is a contraindication to the use of combined oral contraceptives (COCs) because of the increased risk of ischemic stroke. Progestogen-only contraceptive pill (POP) is a safe alternative to COCs and it is preferable in women with cerebrovascular diseases or risk factors for stroke. STUDY DESIGN: Prospective diary-based pilot study. Thirty women with MA (n = 15 who have never used COCs and n = 15 who had previously used COCs were diagnosed according to the International Headache Society criteria. The observational period lasted 9 months during which women filled in a diary with the clinical characteristics of headache attacks. After a 3-month run-in period, each subject received an estrogen-free desogestrel (DSG) (75 mcg/day)-containing OC (Cerazette(®); Schering-Plough, formerly NV Organon, Oss, The Netherlands). Follow-up evaluations were planned at the end of the third and sixth month of treatment. RESULTS: The number (mean±S.D.) of migraine attacks was significantly reduced both in previous COCs users (from 3.9±1.0 to 2.9±0.8; p<.001) and nonusers (from 3.2±0.9 to 2.6±1.3; p<.02) following 6 months of POP use in comparison with the run-in period. Duration of headache pain did not differ significantly in both groups throughout the study. Interestingly enough, a beneficial POP effect on the duration (mean±S.D.) of visual aura (from 16.3±9.5 to 11.4±5.6 min) and on the total duration (mean±S.D.) of neurological symptoms (from 33.6±23.3 to 18.6±18.0 min) was only significantly reported by previous COCs users (p<.001, for both) by the end of the study period. The POP was well tolerated by each woman and the bleeding pattern was variable with a tendency towards infrequent bleeding. CONCLUSIONS: The present study supports the use of the POP containing desogestrel in a population of women with MA and underlines a positive effect on symptoms of aura, especially in MA sensitive to previous use of COCs.
BACKGROUND:Migraine with aura (MA) is a contraindication to the use of combined oral contraceptives (COCs) because of the increased risk of ischemic stroke. Progestogen-only contraceptive pill (POP) is a safe alternative to COCs and it is preferable in women with cerebrovascular diseases or risk factors for stroke. STUDY DESIGN: Prospective diary-based pilot study. Thirty women with MA (n = 15 who have never used COCs and n = 15 who had previously used COCs were diagnosed according to the International Headache Society criteria. The observational period lasted 9 months during which women filled in a diary with the clinical characteristics of headache attacks. After a 3-month run-in period, each subject received an estrogen-free desogestrel (DSG) (75 mcg/day)-containing OC (Cerazette(®); Schering-Plough, formerly NV Organon, Oss, The Netherlands). Follow-up evaluations were planned at the end of the third and sixth month of treatment. RESULTS: The number (mean±S.D.) of migraine attacks was significantly reduced both in previous COCs users (from 3.9±1.0 to 2.9±0.8; p<.001) and nonusers (from 3.2±0.9 to 2.6±1.3; p<.02) following 6 months of POP use in comparison with the run-in period. Duration of headache pain did not differ significantly in both groups throughout the study. Interestingly enough, a beneficial POP effect on the duration (mean±S.D.) of visual aura (from 16.3±9.5 to 11.4±5.6 min) and on the total duration (mean±S.D.) of neurological symptoms (from 33.6±23.3 to 18.6±18.0 min) was only significantly reported by previous COCs users (p<.001, for both) by the end of the study period. The POP was well tolerated by each woman and the bleeding pattern was variable with a tendency towards infrequent bleeding. CONCLUSIONS: The present study supports the use of the POP containing desogestrel in a population of women with MA and underlines a positive effect on symptoms of aura, especially in MA sensitive to previous use of COCs.
Authors: Gabriele S Merki-Feld; Bruno Imthurn; Ronald Langner; Burkhardt Seifert; Andreas R Gantenbein Journal: J Headache Pain Date: 2015-05-01 Impact factor: 7.277
Authors: Simona Sacco; Gabriele S Merki-Feld; Karen Lehrmann Ægidius; Johannes Bitzer; Marianne Canonico; Tobias Kurth; Christian Lampl; Øjvind Lidegaard; E Anne MacGregor; Antoinette MaassenVanDenBrink; Dimos-Dimitrios Mitsikostas; Rossella Elena Nappi; George Ntaios; Per Morten Sandset; Paolo Martelletti Journal: J Headache Pain Date: 2017-10-30 Impact factor: 7.277
Authors: Simona Sacco; Gabriele S Merki-Feld; Karen Lehrmann Ægidius; Johannes Bitzer; Marianne Canonico; Andreas R Gantenbein; Tobias Kurth; Christian Lampl; Øjvind Lidegaard; E Anne MacGregor; Antoinette MaassenVanDenBrink; Dimos-Dimitrios Mitsikostas; Rossella Elena Nappi; George Ntaios; Koen Paemeleire; Per Morten Sandset; Gisela Marie Terwindt; Kjersti Grøtta Vetvik; Paolo Martelletti Journal: J Headache Pain Date: 2018-08-31 Impact factor: 7.277
Authors: Gabriele S Merki-Feld; Peter S Sandor; Rossella E Nappi; Heiko Pohl; Christoph Schankin Journal: Acta Neurol Belg Date: 2021-04-29 Impact factor: 2.396