Prevention of menstrual migraine with perimenstrual transdermal 17-β-estradiol: a randomized, placebo-controlled, double-blind crossover study

Abstract

Marie Landtblom, Editorial Material: Prevention of menstrual migraine with perimenstrual transdermal 17-beta-estradiol: a randomized, placebo-controlled, double-blind crossover study, 2011, Fertility and Sterility, (96), 2, 498-500. http://dx

Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH)

“…In 11 studies treatment was specifically used for headache prevention [12, 29–38], in 8 studies treatment effect on headache was evaluated in women who required treatment for contraception or medical reasons [13–15, 39–43], in 2 studies it was not specifically stated if treatment was prescribed specifically for headache treatment or for other indications [44, 45]. Five studies were performed in women with MO or MA not necessarily related to menstruation [12–14, 41, 43], 10 in MRM or MM [29–39, 43, 45], 4 in PMM [29, 35, 38, 39], and 2 in women with and without headache [15, 40].…”

“…Five studies were performed in women with MO or MA not necessarily related to menstruation [12–14, 41, 43], 10 in MRM or MM [29–39, 43, 45], 4 in PMM [29, 35, 38, 39], and 2 in women with and without headache [15, 40]. …”

“…Drugs which were evaluated to manage migraine in women of reproductive age include the desogestrel progestogen-only pill (POP) [13, 14, 41, 42], extended regimen of oral CHCs [13–15, 30], oral CHCs with shortened pill-free interval [39, 43], oral CHCs with oral estrogen supplementation during the pill-free interval [44], oral CHCs with estradiol supplementation with patch during the pill-free interval [34], the combined hormonal contraceptive patch [40], the combined hormonal contraceptive vaginal ring [45], transdermal estradiol supplementation with gel [31, 32, 35], transdermal estradiol supplementation with patch [29, 33, 37, 38], transdermal estradiol supplementation with patch in women induced in pharmacological menopause [12], and the subcutaneous estrogen implant with cyclical progestogen [36]. …”

“…Four studies assessed the possible benefits of transdermal estradiol supplementation with patch in women with PMM [29, 38] or MM [33, 37]. Three studies were interventional [29, 37, 38] and one was observational [33].…”

Neuroendocrine aspects of migraine in women

“…However, in spite of reducing the severity and duration of MM, the timing and the duration of E2 treatment across the "menstrual window" remain to be further established because of the evidence of a 40% increase in migraine in the 5 days after E2 versus placebo was stopped [37]. On the other hand, a very recent randomized, placebocontrolled, double-blind, crossover trial failed to demonstrate any difference between E2 supplementation (100 μg/24 hours) during 2 weeks perimenstrually and placebo on the number or severity of migraine attacks [38].…”