Evidence map›Paper›PMID 28842849›Full record

Observational studyThe journal of headache and pain2017

Temporal relations in hormone-withdrawal migraines and impact on prevention- a diary-based pilot study in combined hormonal contraceptive users.

Gabriele S Merki-Feld, Gina Epple, Nina Caveng, Bruno Imthurn, Burkhardt Seifert, Peter Sandor, Andreas R Gantenbein

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The journal of headache and pain, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Estrogen modulation of cortical spreading depression.The journal of headache and pain · 2023
    Article
  3. Article
4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Gabriele S Merki-FeldDepartment of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstrasse 10, CH - 8091, Zürich, Switzerland. gabriele.merki@usz.ch.
Gina EppleDepartment of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstrasse 10, CH - 8091, Zürich, Switzerland.
Nina CavengDepartment of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstrasse 10, CH - 8091, Zürich, Switzerland.
Bruno ImthurnDepartment of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstrasse 10, CH - 8091, Zürich, Switzerland.
Burkhardt SeifertEpidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zürich, Zürich, Switzerland.
Peter SandorNeurorehabilitation Rehaclinic Bad Zurzach, Zürich, Switzerland.
Andreas R GantenbeinNeurorehabilitation Rehaclinic Bad Zurzach, Zürich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMenstrually related migraine (MRM) in the hormone-free interval (HFI) of combined hormonal contraceptives (CHC) are according to the ICHD definition also estrogen withdrawal migraines (EWH). MRMs are less responsive to acute medication. Therefore short-term prevention, initiated 1-2 days before onset of the anticipated bleeding and continued for 6 days, is recommended. Such a long prophylactic triptan use might increase the risk for medication overuse headache in women suffering in addition from non-menstrual migraines. In CHC users onset of hormone decline is predictable. It is however unknown, whether the EWHs are rather associated with onset of hormone withdrawal or onset of bleeding. Improved understanding of this relation might contribute to better define and shorten the time interval for prevention.

methodsFor this observational diary-based pilot study we collected data from daily conducted headache diaries of CHC users with MRM in at least two of three cycles, visiting our clinic from 2009 to 2015. We analyzed frequency of migraines for each hormone free day, onset of migraine, onset of bleeding and the relation of migraine to onset of bleeding in the 7-day period following estrogen withdrawal. We identified in addition the onset of migraine attacks lasting more than 1 day (episodes).

resultsForty patient charts met the inclusion criteria, what allowed us to analyze 103 cycles. The mean number of migraine days in the HFI was 2.2 ± 1.6. Migraine started typically on days 1-5 and bleeding on days 3-5. In relation to first day of bleeding, migraines started on days -1 to 4. Almost half of the migraine attacks lasted longer than 24 h, despite the use of rescue medication.

conclusionMRM in CHC users starts on bleeding days -1 to 4, what differs from findings in the natural cycle. Referring to the HFI interval migraine started mostly on days 1-5. According to these data, it seems to be reasonable to initiate short-term prevention at the last day of pill use or the first day of the HFI and continue for 5 days.

Indexed as

MenstruationAdultContraceptives, Oral, CombinedFemaleHumansMiddle AgedMigraine DisordersPilot ProjectsSubstance Withdrawal SyndromeTryptaminesContraceptives, Oral, CombinedTryptaminesCombined pillContraceptionEstrogen-withdrawal headacheMenstrually related migraineMigraine preventionMigraine without aura

Identifiers

PMID28842849
PMCPMC5572786

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.