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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
10:39

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

Published on: June 2, 2014

Contraception and headache.

E Anne MacGregor1

  • 1Barts Health NHS Trust, London, UK.

Headache
|February 26, 2013
PubMed
Summary
This summary is machine-generated.

Combined hormonal contraceptives are generally safe for women with migraine without aura. However, the risks versus benefits for women with migraine with aura are debatable due to a slightly increased stroke risk.

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Area of Science:

  • Gynecology
  • Neurology
  • Pharmacology

Background:

  • Combined hormonal contraceptives (CHCs) are widely used by women of reproductive age.
  • Women frequently inquire about the safety of CHCs, particularly concerning pre-existing headaches or migraines and interactions with headache medications.
  • Migraine with aura is linked to an increased risk of ischemic stroke, while migraine without aura is not.

Purpose of the Study:

  • To review the evidence on the effects of various contraceptive methods on headache and migraine.
  • To identify strategies for minimizing risks and managing triggers associated with CHCs in women with migraine.
  • To discuss guidelines for contraceptive use in women with migraine based on current evidence.

Main Methods:

  • Review of existing scientific literature on contraception, headache, migraine, and ischemic stroke.
  • Analysis of the risks associated with ethinylestradiol, the estrogen component in CHCs.
  • Examination of dose-dependency of stroke risk related to ethinylestradiol.

Main Results:

  • CHCs can be used without restriction by women with migraine without aura.
  • The use of CHCs in women with migraine with aura presents a debatable risk-benefit balance due to a twofold increased risk of ischemic stroke.
  • Low-dose ethinylestradiol pills are safer but still carry some risk of ischemic stroke.

Conclusions:

  • Women with migraine without aura can generally use CHCs safely.
  • Careful consideration of risks and benefits is necessary for women with migraine with aura using CHCs.
  • Management strategies for estrogen withdrawal headache and CHC-associated migraine should be considered.