Can contraceptive pills be used for migraines
- 03 Oct 15:45
- migraine with sex hormones
- main types of pill
- How oral contraceptives affect the course of migraine
- What method of contraception to choose a woman with migraine?
- Oral contraceptives based progestogens
Migraine is one of the most common forms of primaryheadache that occurs in women are 2-3 times more frequently than men. This confirms the role of sex hormones and their fluctuations in the development of the disease. The peak of the incidence is the reproductive age( 25-40 years), which is associated with certain difficulties. One of these is the contraceptive method, since the well-known fact is that taking birth control pills is often associated with a side effect such as headache.
However, hormonal contraceptives shown not only to prevent unwanted pregnancies, often preparations containing estrogens and progestins administered for therapeutic purposes, such as for the treatment of endometriosis, menstrual disorders, pollykystoza treatment of ovarian and other gynecological diseases. How to be in such cases? Continue to take a woman with migraine receiving birth control pills or should I refuse such treatment in favor of other methods? The answer to this question is discussed in detail in this article.
The association of migraines with sex hormones
The role of female sex hormones in the development of migraine confirms the fact that there is a direct relationship between the fluctuations of the hormones in the blood of women and the development of headache attacks. There are 2 types of migraine associated with the female cycle:
The exact cause of the development of migraine is not established today, but it is known that there are three components in the education of migraine attack: vascular, nervous and endocrine. It is with the last and associated development of menstrual migraine. In a number of scientific papers it was proved that increasing the amount of estrogen, reduces the frequency of migraine attacks without aura, but worsens the prognosis of migraine with aura. Thus, estrogen-containing COCs can not be used for migraine with aura, but possibly with a simple type of illness. Some women even experience improvement with oral contraceptives.
In the late luteal and early follicular phase of the cycle( perymenstrualnыy period) just happens maximum reduction amount of estrogen, which leads to the development of headaches. The role of estrogen is also confirmed by the fact that migraine attacks are very common during pregnancy, when there is a constant and stable concentration of estrogen hormones in a woman's body. If migraine is exacerbated during pregnancy or occurs in the first, then it can be argued that there is a migraine with aura( in the pathogenesis of which estrogens play a negative role).
Thus, the first thing to know if a woman with migraine wants to take oral contraceptives is what kind of illness is present in this case. Depending on this and on the availability of other risk factors for stroke, the appearance and composition of birth control pills will be selected, and possibly, that the specific patient of the appointment of the COC will be categorically contraindicated and another kind of contraception should be selected.
main types of pill
the combined oral contraceptive may include two active substances( synthetic analogs of natural sex hormones):
Ethinylestradiol is used as an estrogen component in modern tablets, and progesterones exist for several generations, which are called progestins. As a rule, modern COCs contain progestins 3 and 4 generations.
. Contraceptive pills differ mainly in terms of estrogen( high-low and micro-dosed), at present, highly dosed drugs are rarely administered;in the form of progestin, which is part of the pills;by phase( mono, two, and three-phase), two-phase contraceptives are practically not used. Also, separate preparations that contain only progestins and do not have estrogen in its composition. They can be used for breastfeeding and in the presence of contraindications for the use of COCs that contain estrogens, for example, migraine with aura.
How does oral contraceptives affect the migration of migraines
Recent clinical trials have shown that taking birth control pills may trigger migraines, and in the case of pre-existing illness, it may cause aggravation of its course, increased migraine headaches, and the development of insensitivity to migraine preparations.
But this effect does not always affect birth control pills. This is due in the first place to the fact that migraine is not a single disease, but a heterogeneous group of pathologies. For example, some women, on the other hand, feel relief from migraine attacks or their complete cessation against the background of the use of combined oral contraceptives( COCs) and use these drugs as a prophylactic. Usually such a phenomenon can be observed with migraine without aura. It is also important to take into account the composition of the pills, because not all of them are the same.
should choose an oral contraceptive Migraine with aura is a completely different story. According to the latest statistics, this type of headache increases the risk of developing ischemic stroke, so conducting differential diagnosis of headaches in women who are planning to take COCs is a very important task, since oral contraceptives further increase the chance of stroke in women with migraine, which is accompanied by aura. The risk of stroke in women with migraine receiving COCs is increased by 2-4 times compared with those who do not use oral contraceptives and 8-16 times when compared to women without migraine and without taking COCs.
Basically, such data refer to preparations containing estrogen, pills containing progestins are safer. The World Health Organization has identified the possibility of their admission to migraine women with the following phrase: "Accepting oral contraceptives for women with migraine attacks is possible because their superiority exceeds the risk," but it still exists.
What method of contraception to choose a woman with migraine?
According to modern gynecological recommendations, the use of estrogen containing oral contraceptives for women with migraine, especially with aura, is contraindicated. Advantage should be given to barrier contraceptive methods, the use of intrauterine helix or oral progestogen-based contraceptives.
contraceptive method. As for COCs, the algorithm for their use in migraines is as follows:
It's important to remember! Specific drugs prescribed for the relief of migraine attacks( tryptans) are not contraindicated in the use of oral contraceptives.
Oral contraceptives based on the progestogens
Progestogen-based birth control pills may be used in patients with migraine( in some cases, even with aura).They do not contain estrogen hormones, which are a link in the pathogenesis of menstrual migraine. Such preparations can be found also under the name of "mini-dust".
They are shown to prevent unwanted pregnancy in women over 40 years of age, as well as in nursing mothers. These contraceptive pills may also be used in migraine patients who are contraindicated in combination with estrogen-containing drugs. The contraceptive effect in the mini-drink is slightly lower than that of the COC, but the latest generation of drugs is practically inferior to them in this.
Video Transmission of Oral Contraceptives:
Oral Contraceptives. When it is dangerous, when it is useful.
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Choosing a drug for permanent contraception is a complicated and serious task to be solved by a doctor alone. Otherwise, there is a high risk of side effects, up to a stroke.