Use of combined oral contraceptives and headaches

The study was designed to examine the certain patterns of combined oral contraceptive use in women of childbearing potential and evaluate the relationship between the use of combined oral contraceptives and headaches, bad habits, type of work, and concomitant diseases.

In total, 194 randomly selected women aged 18 to 40 years who visited a gynecologist for preventive gynecological examination were surveyed. Respondents were categorized as combined oral contraceptive users (n=116; study group) and nonusers (n=78; control group). An anonymous questionnaire developed by the authors of this study and a standardized scale called the Migraine Disability Assessment Scale (MIDAS) were used for the survey.

A multivariate logistic regression analysis demonstrated a significantly higher prevalence of combined oral contraceptive use in women older than 20 years (odds ratio, 6.0; 95% CI, 2.6-14), better educated women (odds ratio, 5.7; 95% CI, 2.1-15.2), and women reporting a steady sexual partner (odds ratio, 4.0; 95% CI, 1.5-11.0). Relationship between headaches and use of combined oral contraceptives as well as other factors were analyzed in a group of 178 respondents; the rest 16 respondents reported not having headaches at all. The prevalence of reported minimal-to-mild and moderate-to-severe impact of headaches on daily activities did not differ significantly between the study and control groups, women with and without bad habits, and white-collar and blue-collar groups (P>0.05). However, women with concomitant diseases significantly more often reported moderate-to-severe impact on daily activities due to headaches (P<0.01). Differences in impact of headaches on daily activities between women using combined oral contraceptives containing 20 or less μg of ethinylestradiol and 30 or more μg of ethinylestradiol did not differ significantly.

The prevalence of combined oral contraceptive use was higher in women older than 20 years, better educated women, and women reporting a steady sexual partner. The impact of headaches on daily activities did not differ significantly between the combined oral contraceptive users and nonusers.