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Kontrazeption bei Frauen mit Migräne


Merki-Feld, G S (2013). Kontrazeption bei Frauen mit Migräne. Gynaekologische Endokrinologie, 11(3):184-187.

Abstract

Background
Migraine is a complex, disabling neurological condition characterized by recurrent episodes of headache. It affects up to 15 % of the adult population, whereby women of reproductive age are more frequently affected than men. Estrogens have been shown to play a pivotal role in migraine pathophysiology. Migraineurs are at increased for cerebral stroke and migraine is associated with an elevated risk for cardiovascular events. This risk has been shown to be especially high in migraine with aura. Contraception should not expose migraineurs to further health risks.
Contraception using gestagens
In contrast to combined hormonal contraceptives (CHC), progestin-only contraceptives (POC) are not associated with an elevated risk for ischemic attacks. Preliminary data even demonstrate the reduction of monthly migraine days, auras and use of analgetics with the use of desogestrel 75 μg.
Other methods
CHC should only be used in exceptional cases. Migraine with aura is an absolute contraindication. Copper-releasing intrauterine devices do not affect the course of migraine. Hormone-withdrawal migraines can sometimes be successfully treated with use of CHC in a continuous regime. However, the affect of this therapy on the risk for ischemic attacks and ischemic stroke remains unclear; therefore, gestagens represent the preferred approach.

Abstract

Background
Migraine is a complex, disabling neurological condition characterized by recurrent episodes of headache. It affects up to 15 % of the adult population, whereby women of reproductive age are more frequently affected than men. Estrogens have been shown to play a pivotal role in migraine pathophysiology. Migraineurs are at increased for cerebral stroke and migraine is associated with an elevated risk for cardiovascular events. This risk has been shown to be especially high in migraine with aura. Contraception should not expose migraineurs to further health risks.
Contraception using gestagens
In contrast to combined hormonal contraceptives (CHC), progestin-only contraceptives (POC) are not associated with an elevated risk for ischemic attacks. Preliminary data even demonstrate the reduction of monthly migraine days, auras and use of analgetics with the use of desogestrel 75 μg.
Other methods
CHC should only be used in exceptional cases. Migraine with aura is an absolute contraindication. Copper-releasing intrauterine devices do not affect the course of migraine. Hormone-withdrawal migraines can sometimes be successfully treated with use of CHC in a continuous regime. However, the affect of this therapy on the risk for ischemic attacks and ischemic stroke remains unclear; therefore, gestagens represent the preferred approach.

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Additional indexing

Item Type:Journal Article, not refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Reproductive Endocrinology
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:2013
Deposited On:21 Jan 2014 12:11
Last Modified:05 Apr 2016 17:28
Publisher:Springer
ISSN:1610-2894
Publisher DOI:https://doi.org/10.1007/s10304-012-0535-1

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