Migraine and Oral Contraceptives

Abstract

SYNOPSIS To ascertain the effect of oral contraceptives on migraine, an analysis was made of self administered questionnaires from 886 non‐pregnant migraine sufferers aged 15‐45 years (241 Pill takers, 290 ex‐takers and 355 non‐takers), together with a 3 months record of migraine attacks in 416 women covering 1,239 menstruations. Migraine was worse on the Pill in 34% of takers and 60% of ex‐takers. On stopping the Pill 39% of ex‐takers improved. During menstruation 35% of attacks occurred in takers, 32% of attacks in ex‐takers and 27% of attacks in non‐takers. A significant increase in migraine at mid‐cycle was most marked among those whose migraine increased on the Pill and those with severe attacks. Other significant differences are reported relating to length of menstrual cycle. Deterioration of migraine on Pill related to age, parity, cycle length, menstrual attacks, relief of migraine in late pregnancy and onset after pregnancy.

Latent class and genetic analysis does not support migraine with aura and migraine without aura as separate entities

“…Further support for a relationship between hormonal variations and migraine includes reports of the oral contraceptive pill precipitating a first attack of migraine, or worsening or improving the frequency and severity of existing attacks [Dalton, 1976;Kudrow, 1975;Larson-Cohn and Lundberg, 1970;Mears and Grant, 1962;Phillips, 1968;Ryan, 1978;Whitty et al, 1966]. In addition, many women with migraine have fewer attacks during pregnancy [Callaghann, 1968;Nattero, 1982;Somerville, 1972], although the condition may be exacerbated in the postpartum period [Stein, 1981].…”

Aspects of Human Chronopathology

“…Circamensual rhythmicity in migraine headache is rather well recognized both in the clinic as well as in the literature (Green 1967;Dalton 1973Dalton , 1976Kashiwagi et al 1972;Dalessio 1973;Pollmann and Harris 1978). Figure 44 presents the data from Dalton (1973), 512 headaches experienced by 52 regularly menstruating women not taking oral contraceptives.…”

“…The prominent circamensual rhythmicity in migraine was detectable also in oral contraceptive users. In a group of oral contraceptive users and exusers, the incidence of migraine during the premenstrum and menses was more than twice that expected had its occurrence been randomly distributed over the menstrual cycle (Dalton 1973(Dalton , 1976(Dalton , 1977. Pollmann and Harris (1978) studied the onset of continuous pain caused by dental caries in 543 patients primarily between the ages of 18 and 25 years.…”

“…Circamensual Rhythms Dalton (1964Dalton ( , 1967Dalton ( , 1973Dalton ( , 1976Dalton ( , 1977 investigated the influence of menstruation on many disorders including glaucoma. Figure 41 presents her findings for the distribution of ocular symptoms in women with diagnosed closed-angle and simple chronic glaucoma.…”

Adolescent issues in migraine: A focus on menstrual migraine

“…Many young women use oral contraceptive (OC) pills for regulation of their cycle as well as birth control. When an adolescent or young woman with migraine begins OC therapy, the migraine may improve, worsen, remain stable, or occur for the fi rst time [ 27 ]. Women in whom migraines worsen typically experience this during the placebo week.…”