title: Improvement of migraine with change from combined hormonal contraceptives to progestin-only contraception with desogestrel: How strong is the effect of taking women off combined contraceptives?
abstract: Migraine is a disabling headache disorder, which affects up to 17% of the female population. Oestrogen withdrawal during the menstrual cycle or the hormone-free interval in users of combined hormonal contraceptives (CHC) plays a pivotal role. Two diary-based studies demonstrated a positive impact of the progestin-only pill (POP) desogestrel 75 μg on the frequency of the migraine attacks and pain intensity. In both studies, CHC users as well as nonusers were included, which makes it difficult to distinguish between the effect of taking women off the CHC and the benefit of the POP itself. With the present study, we compared the therapeutic effect of the POP desogestrel 75 μg on migraine in current CHC users and nonusers. We found a positive influence of desogestrel on migraine not only in women who switched from CHCs to desogestrel, but also in those who had not used hormones over 6 months before starting it. Our findings need to be confirmed in prospectively conducted studies with larger sample size.
authors.affiliation: a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland.
authors.forename: Gabriele S
authors.initials: GS
authors.lastname: Merki-Feld
authors.affiliation: a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland.
authors.forename: Bruno
authors.initials: B
authors.lastname: Imthurn
authors.affiliation: a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland.
authors.forename: Raghvendran
authors.initials: R
authors.lastname: Dubey
authors.affiliation: b Headache outpatient Clinic, Department of Neurorehabilitation , Reha Clinic Bad Zurzach & Baden , Bad Zurzach , Switzerland.|c Headache and Pain Unit, Department for Neurology , University Hospital Zürich , Zurich , Switzerland.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Sándor
authors.affiliation: b Headache outpatient Clinic, Department of Neurorehabilitation , Reha Clinic Bad Zurzach & Baden , Bad Zurzach , Switzerland.|c Headache and Pain Unit, Department for Neurology , University Hospital Zürich , Zurich , Switzerland.
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Gantenbein
mesh_terms: D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D017135:Desogestrel / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008499:Medical Records; D008881:Migraine Disorders / Q000188:drug therapy*; D010147:Pain Measurement; D011372:Progestins / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D003277:Contraceptives, Oral, Combined; D011372:Progestins; D017135:Desogestrel
keywords: Migraine; combined hormonal contraception; cortical excitability; desogestrel; hormone withdrawal; stroke