title: Modulation of nociceptive threshold by combined hormonal contraceptives in women with oestrogen-withdrawal migraine attacks: a pilot study.
abstract: BACKGROUND
  Menstrually-related headache and headaches associated with oestrogen withdrawal are common conditions, whose pathophysiology has not been completely elucidated. In this study we evaluated the influence of combined hormonal contraceptives (CHC) on pain threshold in women presenting migraine attacks during hormone-free interval.
  
  
  RESULTS
  Eleven women with migraine attacks recurring exclusively during the oestrogen-withdrawal period were studied with the nociceptive flexion reflex, a neurophysiological assessment of the pain control systems, during the third week of active treatment and during the hormone-free interval. During the hormone-free interval, nociceptive withdrawal reflex threshold was significantly lower (12.8 ± 8.0 mA) as compared to the third week of hormonal treatment (15.6 ± 6.6 mA) (p = 0.02). No change was observed in the pain perceived and in the temporal summation.
  
  
  CONCLUSIONS
  Oestrogen withdrawal may mediate an increased sensitivity to somatosensory stimuli in women with migraine attacks recurring during the hormone-free interval.
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy. rob.deicco@gmail.com.|Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. rob.deicco@gmail.com.
authors.forename: Roberto
authors.identifier: http://orcid.org/0000-0001-9415-4948
authors.initials: R
authors.lastname: De Icco
authors.affiliation: Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy.|Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cucinella
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.|Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: De Paoli
authors.affiliation: Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy.|Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Martella
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Sances
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Bitetto
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.|Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sandrini
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nappi
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.|Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tassorelli
authors.affiliation: Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy.|Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
mesh_terms: D000328:Adult; D000700:Analgesics; D000818:Animals; D003270:Contraceptive Agents; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects* / Q000493:pharmacokinetics; D004968:Estrogens, Non-Steroidal; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000139:chemically induced* / Q000517:prevention & control; D017288:Pain Threshold / Q000502:physiology; D010865:Pilot Projects; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000700:Analgesics; D003270:Contraceptive Agents; D003277:Contraceptives, Oral, Combined; D004968:Estrogens, Non-Steroidal
keywords: Combined hormonal contraceptives; Menstrually related migraine; Nociceptive withdrawal reflex; Oestrogen withdrawal headache