Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?

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作者
Rossella E Nappi
Gabriele S Merki-Feld
Erica Terreno
Alice Pellegrinelli
Michele Viana
机构
[1] IRCCS S. Matteo Foundation,Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause
[2] University of Pavia,Department of Clinical, Surgical, Diagnostic and Paediatric Sciences
[3] University Hospital Zürich,Clinic for Reproductive Endocrinology
[4] Headache Science Center - National Neurological Institute C. Mondino,Research Center for Reproductive Medicine, Unit of Obstetrics and Gynecology
[5] IRCCS Policlinico ‘San Matteo’,undefined
来源
关键词
Migraine with aura (MA); Migraine without aura (MO); Combined hormonal contraceptives (CHCs); Combined oral contraceptives (COCs); Progestogen-only contraception; Desogestrel-only pill; Venous thromboembolism (VTE); Stroke;
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摘要
A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke.
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