Abstract | BACKGROUND: STUDY DESIGN: This was a prospective diary-based pilot study. Thirty-two women (age >35 years) [n=18 who had never used combined oral contraceptives (COCs) and n=14 who had previously used COCs] diagnosed with MRMs according to the International Headache Society criteria were included. During the observational period, women filled in a diary with the clinical characteristics of migraine attacks. After a three-cycle run-in period, each subject received a COC containing E2V/DNG (Qlaira®/Natazia®; Bayer HealthCare, Berlin, Germany) administered using an estrogen step-down and progestogen step-up approach. Follow-up evaluations were scheduled at the last cycle of run-in and at the third and sixth cycles of treatment. RESULTS: The number of migraine attacks was significantly reduced at the third (p<.001) and sixth cycles (p<.001) in comparison with the run-in period. A similar result was evident for the duration (p<.001 at the third and p<.001 at the sixth cycle) as well as for the severity of head pain (p<.001 at the third and p<.001 at the sixth month). Indeed, a significantly lower number of analgesics were used at the third cycle (p<.001) in comparison with baseline, and a further decrease was evident at the sixth cycle (p<.001) in comparison with the third cycle of E2V/DNG use. Interestingly, duration and severity of head pain were significantly correlated with the number of days of dysmenorrhea at the third cycle (r=.89, p=.000 and r=.67, p=.02; respectively) and at the sixth cycle (r=.76, p=.000 and r=.62, p=.04; respectively) in women without complete remission of menstrual cramps during the study period. CONCLUSIONS: The present diary-based pilot study indicates that the use of a pill containing EV2/DNG for six cycles has a positive effect in women with MRM and suggests an association between dysmenorrhea with COCs use as a potential feature of refractory head pain.
|
Authors | Rossella E Nappi, Erica Terreno, Grazia Sances, Ellis Martini, Silvia Tonani, Valentina Santamaria, Cristina Tassorelli, Arsenio Spinillo |
Journal | Contraception
(Contraception)
Vol. 88
Issue 3
Pg. 369-75
(Sep 2013)
ISSN: 1879-0518 [Electronic] United States |
PMID | 23453784
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Analgesics
- Contraceptives, Oral, Combined
- Drug Combinations
- estradiol valerate-dienogest
- dienogest
- Estradiol
- Nandrolone
|
Topics |
- Adult
- Analgesics
(administration & dosage)
- Body Mass Index
- Contraceptives, Oral, Combined
(administration & dosage)
- Drug Combinations
- Dysmenorrhea
(complications, drug therapy)
- Estradiol
(administration & dosage, analogs & derivatives)
- Female
- Humans
- Italy
- Menstruation
- Migraine Disorders
(drug therapy, etiology, physiopathology)
- Nandrolone
(administration & dosage, analogs & derivatives)
- Pilot Projects
- Prospective Studies
- Treatment Outcome
|