![]() Low dose combined hormonal contraceptives (CHCs) have become the method of choice and the availability of new progestins (third- and fourth-generation) has allowed to achieve non-contraceptive benefits in comparison to older progestins (second – generation) Among the several forms of contraceptives available, hormonal contraceptives are the most popular reversible method, both in USA and Europe and the “Pill” is the most used The reproductive life is characterized by the need of reliable and convenient methods of contraception. It is then mostly a female disorder, that it is active in particular during the fertile period of the women’ life with a peak of prevalence in their 20s and 30s and its cumulative lifetime prevalence is 43% in women and 18% in men Migraine affects about 18% of women and 6% of men in USA and Western Europe Differences between MA and MO should also be taken into account in further studies.Įpidemiology of migraine and combined hormonal contraceptive (CHC) use Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. ![]() Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75 μg has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. 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. 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). Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life.
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