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Contraceptive Options for Women with Headache Disease

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Contraception for the Medically Challenging Patient

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Abstract

This chapter addresses the effects of hormonal contraceptives on headache, in particular, migraine. The definition, incidence, and prevalence for migraine with and without aura are reviewed. The discussion explores the stroke risk associated with both hormonal contraception and migraine and also includes the special contraceptive concerns regarding estrogen withdrawal headache, menstrual migraine, and idiopathic intracranial hypertension. A case-based approach is used to allow practitioners an understanding of how to implement best practice recommendations, especially the selection of appropriate candidates for initiation of hormone-containing contraceptives, and decision-making about method continuation among women complaining of headache while taking hormonal contraceptives.

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References

  1. Stewart WF, Wood C, Reed ML, Roy J, Lipton RB, AMPP Advisory Group. Cumulative lifetime migraine incidence in women and men. Cephalalgia. 2008; 28:1170–8.

    Article  CAS  PubMed  Google Scholar 

  2. Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Reasons U.S. women have abortions: quantitative and qualitative perspectives. Perspect Sex Reprod Health. 2005;37:110–8.

    Article  PubMed  Google Scholar 

  3. Rosenberg MJ, Waugh MS. Oral contraceptive discontinuation: a prospective evaluation of frequency and reasons. Am J Obstet Gynecol. 1998;179:577–82.

    Article  CAS  PubMed  Google Scholar 

  4. Rosenberg MJ, Waugh MS, Long S. Unintended pregnancies and use, misuse and discontinuation of oral contraceptives. J Reprod Med. 1995;40:355–60.

    CAS  PubMed  Google Scholar 

  5. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF, AMPP Advisory Group. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343–9.

    Article  CAS  PubMed  Google Scholar 

  6. MacGregor EA. Migraine and use of combined hormonal contraceptives: a clinical review. J Fam Plann Reprod Health Care. 2007;33:159–69.

    Article  PubMed  Google Scholar 

  7. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd ed. Cephalalgia. 2004;24 suppl 1:9–160.

    Google Scholar 

  8. Charles A. Advances in the basic and clinical science of migraine. Ann Neurol. 2009;65:491–8.

    Article  PubMed  Google Scholar 

  9. Russell MB, Olesen J. A nosographic analysis of the migraine aura in a general population. Brain. 1996; 119(Pt 2):355–61.

    Article  PubMed  Google Scholar 

  10. Merikangas KR, Fenton BT, Cheng SH, Stolar MJ, Risch N. Association between migraine and stroke in a large-scale epidemiological study of the United States. Arch Neurol. 1997;54:362–8.

    Article  CAS  PubMed  Google Scholar 

  11. Chang CL, Donaghy M, Poulter N, The World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Migraine and stroke in young women: case–control study. BMJ. 1999;318:13–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. MacClellan LR, Giles W, Cole J, Wozniak M, Stern B, Mitchell BD, et al. Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke. 2007;38:2438–45.

    Article  PubMed  Google Scholar 

  13. Kurth T, Slomke MA, Kase CS, Cook NR, Lee IM, Gaziano JM, et al. Migraine, headache, and the risk of stroke in women: a prospective study. Neurology. 2005;64:1020–6.

    Article  CAS  PubMed  Google Scholar 

  14. Kurth T, Gaziano JM, Cook NR, Logroscino G, Diener HC, Buring JE. Migraine and risk of cardiovascular disease in women. JAMA. 2006;296: 283–91.

    Article  CAS  PubMed  Google Scholar 

  15. Etminan M, Takkouche B, Isorna FC, Samii A. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ. 2005;330:63–6.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Henrich JB, Horwitz RI. A controlled study of ischemic stroke risk in migraine patients. J Clin Epidemiol. 1989;42:773–80.

    Article  CAS  PubMed  Google Scholar 

  17. Carolei A, Marini C, De Matteis G, The Italian National Research Council Study Group on Stroke in the Young . History of migraine and risk of cerebral ischaemia in young adults. Lancet. 1996;347:1503–6.

    Article  CAS  PubMed  Google Scholar 

  18. Tzourio C, Iglesias S, Hubert JB, Visy JM, Alpérovitch A, Tehindrazanarivelo A, et al. Migraine and risk of ischaemic stroke: a case–control study. BMJ. 1993; 307:289–92.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Tzourio C, Tehindrazanarivelo A, Iglésias S, Alpérovitch A, Chedru F, d’Anglejan-Chatillon J, et al. Case–control study of migraine and risk of ischaemic stroke in young women. BMJ. 1995;310: 830–3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Bousser MG, Conard J, Kittner S, de Lignières B, MacGregor EA, Massiou H, The International Headache Society Task Force on Combined Oral Contraceptives & Hormone Replacement Therapy, et al. Recommendations on the risk of ischaemic stroke associated with use of combined oral contraceptives and hormone replacement therapy in women with migraine. Cephalalgia. 2000;20:155–6.

    Article  CAS  PubMed  Google Scholar 

  21. Petitti DB, Sidney S, Bernstein A, Wolf S, Quesenberry C, Ziel HK. Stroke in users of low-dose oral contraceptives. N Engl J Med. 1996;335:8–15.

    Article  CAS  PubMed  Google Scholar 

  22. Stang PE, Carson AP, Rose KM, Mo J, Ephross SA, Shahar E, et al. Headache, cerebrovascular symptoms, and stroke: the Atherosclerosis Risk in Communities Study. Neurology. 2005;64:1573–7.

    Article  CAS  PubMed  Google Scholar 

  23. Lidegaard Ø. Oral contraception and risk of a cerebral thromboembolic attack: results of a case–control study. BMJ. 1993;306:956–63.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Lidegaard Ø, Kreiner S. Contraceptives and cerebral thrombosis: a five-year national case control study. Contraception. 2002;65:197–205.

    Article  CAS  PubMed  Google Scholar 

  25. Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA. 2000;284:72–8.

    Article  CAS  PubMed  Google Scholar 

  26. Heinemann LA, Lewis MA, Spitzer WO, Thorogood M, Guggenmoos-Holzmann I, Bruppacher R, Transnational Research Group on Oral Contraceptives and the Health of Young Women. Thromboembolic stroke in young women. A European case–control study on oral contraceptives. Contraception. 1998;57:29–37.

    Article  CAS  PubMed  Google Scholar 

  27. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case–control study. Lancet. 1996;348:498–505.

    Article  Google Scholar 

  28. Lidegaard O, Lokkegaard E, Jenson A, Skovlund C, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012;366:2257–66.

    Article  CAS  PubMed  Google Scholar 

  29. World Health Organization. Medical eligibility criteria for contraceptive use. 4th ed. Geneva: World Health Organization; 2009.

    Google Scholar 

  30. Donaghy M, Chang CL, Poulter N, on behalf of the European Collaborators of the World Health Organisation Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Duration, frequency, recency, and type of migraine and the risk of ischaemic stroke in women of childbearing age. J Neurol Neurosurg Psychiatry. 2002; 73:747–50.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. MacGregor EA. Menstrual migraine: a clinical review. J Fam Plann Reprod Health Care. 2007;33: 36–47.

    Article  PubMed  Google Scholar 

  32. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case–control study. Contraception. 1998;57:315–24.

    Article  Google Scholar 

  33. Schwartz SM, Petitti DB, Siscovick DS, Longstreth Jr WT, Sidney S, Raghunathan TE, et al. Stroke and use of low-dose oral contraceptives in young women: a pooled analysis of two US studies. Stroke. 1998; 29:2277–84.

    Article  CAS  PubMed  Google Scholar 

  34. Lidegaard Ø. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease. Br J Obstet Gynaecol. 1995;102: 153–9.

    Article  CAS  PubMed  Google Scholar 

  35. Schürks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009;339:b3914.

    Article  PubMed Central  PubMed  Google Scholar 

  36. ACOG Committee on Practice Bulletins-Gynecology. Practice Bulletin ACOG. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2006;107:1453–72.

    Article  Google Scholar 

  37. Duncan J, Corbett J, Wall M. The incidence of pseudotumor cerebri population studies in Iowa and Louisiana. Arch Neurol. 1988;45(8):875–7.

    Article  Google Scholar 

  38. Bousse V, Bruce B, Newman N. Update on the pathophysiology of idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 2012;83:488–94.

    Article  Google Scholar 

  39. Robinson JA, Burke AE. Obesity and hormonal contraceptive efficacy. Womens Health. 2013;9(5):453–66.

    CAS  Google Scholar 

  40. Edelman A, Jensen J. Obesity and hormonal contraception: safety and efficacy. Semin Reprod Med. 2012;30(06):479–85.

    Article  CAS  PubMed  Google Scholar 

  41. Granella F, Sances G, Pucci E, Nappi RE, Ghiotto N, Napp G. Migraine with aura and reproductive life events: a case control study. Cephalalgia. 2000; 20:701–7.

    Article  CAS  PubMed  Google Scholar 

  42. Loder EW, Buse DC, Golub JR. Headache and combination estrogen-progestin oral contraceptives: integrating evidence, guidelines, and clinical practice. Headache. 2005;45:224–31.

    Article  PubMed  Google Scholar 

  43. Larsson-Cohn U, Lundberg PO. Headache and treatment with oral contraceptives. Acta Neurol Scand. 1970;46:267–78.

    Article  CAS  PubMed  Google Scholar 

  44. Loder EW, Buse DC, Golub JR. Headache as a side effect of combination estrogen-progestin oral contraceptives: a systematic review. Am J Obstet Gynecol. 2005;193(3 Pt 1):636–49.

    Article  CAS  PubMed  Google Scholar 

  45. Somerville BW, Carey HM. The use of continuous progestogen contraception in the treatment of migraine. Med J Aust. 1970;1:1043–5.

    CAS  PubMed  Google Scholar 

  46. Davies P, Fursdon-Davies C, Rees MC. Progestogens for menstrual migraine. J Br Menopause Soc. 2003; 9:134.

    PubMed  Google Scholar 

  47. Croxatto HB, Mäkaräinen L. The pharmacodynamics and efficacy of Implanon. An overview of the data. Contraception. 1998;58:91S–7.

    Article  CAS  PubMed  Google Scholar 

  48. Fotherby K. Twelve years of clinical experience with an oral contraceptive containing 30 micrograms ethinyloestradiol and 150 micrograms desogestrel. Contraception. 1995;51:3–12.

    Article  CAS  PubMed  Google Scholar 

  49. MacGregor EA, Frith A, Ellis J, Aspinall L, Hackshaw A. Incidence of migraine relative to menstrual cycle phases of rising and falling estrogen. Neurology. 2006;67:2154–8.

    Article  CAS  PubMed  Google Scholar 

  50. Sulak PJ, Scow RD, Preece C, Riggs MW, Kuehl TJ. Hormone withdrawal symptoms in oral contraceptive users. Obstet Gynecol. 2000;95:261–6.

    Article  CAS  PubMed  Google Scholar 

  51. Silberstein SD. The role of sex hormones in headache. Neurology. 1992;42(3 suppl2):37–42.

    CAS  PubMed  Google Scholar 

  52. Silberstein S. Headache and female hormones: what you need to know. Curr Opin Neurol. 2001;14: 323–33.

    Article  CAS  PubMed  Google Scholar 

  53. MacGregor EA, Hackshaw A. Prevalence of migraine on each day of the natural menstrual cycle. Neurology. 2004;63:351–3.

    Article  PubMed  Google Scholar 

  54. MacGregor EA, Frith A, Ellis J, Aspinall L, Hackshaw A. Prevention of menstrual attacks of migraine: a double-blind placebo-controlled crossover stud. Neurology. 2006;67:2159–63.

    Article  CAS  PubMed  Google Scholar 

  55. MacGregor EA, Hackshaw A. Prevention of migraine in the pill-free interval of combined oral contraceptives: a double-blind, placebo-controlled pilot study using natural oestrogen supplements. J Fam Plann Reprod Health Care. 2002;28:27–31.

    Article  PubMed  Google Scholar 

  56. Edelman A, Gallo MF, Nichols MD, Jensen JT, Schulz KF, Grimes DA. Continuous versus cyclic use of combined oral contraceptives for contraception: systematic Cochrane review of randomized controlled trials. Hum Reprod. 2006;21:573–8.

    Article  CAS  PubMed  Google Scholar 

  57. Johannes CB, Linet MS, Stewart WF, Celentano DD, Lipton RB, Szklo M. Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology. 1995;45:1076–82.

    Article  CAS  PubMed  Google Scholar 

  58. Facchinetti F, Bonellie G, Kangasniemi P, Pascual J, Shuaib A, The Sumatriptan Menstrual Migraine Study Group. The efficacy and safety of subcutaneous sumatriptan in the acute treatment of menstrual migraine. Obstet Gynecol. 1995;86:911–6.

    Article  CAS  PubMed  Google Scholar 

  59. Solbach MP, Waymer RS. Treatment of menstruation-associated migraine headache with subcutaneous sumatriptan. Obstet Gynecol. 1993;82:769–72.

    CAS  PubMed  Google Scholar 

  60. Sances G, Martignoni E, Fioroni L, Blandini F, Facchinetti F, Nappi G. Naproxen sodium in menstrual migraine prophylaxis: a double-blind placebo controlled study. Headache. 1990;30:705–9.

    Article  CAS  PubMed  Google Scholar 

  61. Ashkenazi A, Silberstein S. Menstrual migraine: a review of hormonal causes, prophylaxis and treatment. Expert Opin Pharmacother. 2007;8: 1605–13.

    Article  CAS  PubMed  Google Scholar 

  62. Al-Waili NS. Treatment of menstrual migraine with prostaglandin synthesis inhibitor mefenamic acid: double-blind study with placebo. Eur J Med Res. 2000;5:176–82.

    CAS  PubMed  Google Scholar 

  63. Mannix LK, Martin VT, Cady RK, Diamond ML, Lener SE, White JD, et al. Combination treatment for menstrual migraine and dysmenorrhea using sumatriptan-naproxen: two randomized controlled trials. Obstet Gynecol. 2009;114:106–13.

    Article  PubMed  Google Scholar 

  64. Massiou H, MacGregor EA. Evolution and treatment of migraine with oral contraceptives. Cephalalgia. 2000;20:170–4.

    Article  CAS  PubMed  Google Scholar 

  65. Pringsheim T, Davenport WJ, Dodick D. Acute treatment and prevention of menstrually related migraine headache: evidence-based review. Neurology. 2008; 70:1555–63.

    Article  CAS  PubMed  Google Scholar 

  66. de Lignières B, Vincens M, Mauvais-Jarvis P, Mas JL, Touboul PJ, Bousser MG. Prevention of menstrual migraine by percutaneous oestradiol. Br Med J (Clin Res Ed). 1986;293:1540.

    Article  Google Scholar 

  67. Dennerstein L, Morse C, Burrows G, Oats J, Brown J, Smith M. Menstrual migraine: a double-blind trial of percutaneous estradiol. Gynecol Endocrinol. 1988;2: 113–20.

    Article  CAS  PubMed  Google Scholar 

  68. Menon R, Bushnell CD. Headache and pregnancy. Neurologist. 2008;14:108–19.

    Article  PubMed  Google Scholar 

  69. Contag SA, Mertz HL, Bushnell CD. Migraine during pregnancy: is it more than a headache? Nat Rev Neurol. 2009;5:449–56.

    Article  PubMed  Google Scholar 

  70. Kelman L. Women’s issues of migraine in tertiary care. Headache. 2004;44:2–7.

    Article  PubMed  Google Scholar 

  71. Scharff L, Marcus DA, Turk DC. Headache during pregnancy and in the postpartum: a prospective study. Headache. 1997;37:203–10.

    Article  CAS  PubMed  Google Scholar 

  72. Aegidius K, Zwart JA, Hagen K, Stovner L. The effect of pregnancy and parity on headache prevalence: the Head-HUNT study. Headache. 2009;49:851–9.

    Article  PubMed  Google Scholar 

  73. Bialer M, Doose DR, Murthy B, Curtin C, Curtin C, Wang SS, Twyman RE, et al. Pharmacokinetic interactions of topiramate. Clin Pharmacokinet. 2004; 43(12):763–80.

    Article  CAS  PubMed  Google Scholar 

  74. Marik PE, Plante LA. Venous thromboembolic disease and pregnancy. N Engl J Med. 2008;359:2025–33.

    Article  CAS  PubMed  Google Scholar 

  75. Greer IA. Thrombosis in pregnancy: maternal and fetal issues. Lancet. 1999;353:1258–65.

    Article  CAS  PubMed  Google Scholar 

  76. Kujovich JL. Hormones and pregnancy: thromboembolic risks for women. Br J Haematol. 2004;126: 443–54.

    Article  PubMed  Google Scholar 

  77. Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton 3rd LJ. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med. 2005;143:697–706.

    Article  PubMed  Google Scholar 

  78. NIH Consensus Development. Prevention of venous thrombosis and pulmonary embolism. JAMA. 1986; 256:744–9.

    Article  Google Scholar 

  79. Kittner SJ, Stern BJ, Feeser BR, Hebel R, Nagey DA, Buchholz DW, et al. Pregnancy and the risk of stroke. N Engl J Med. 1996;335:768–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

    Deborah Bartz M.D., M.P.H.

  2. Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA

    M. Angela O’Neal M.D.

  3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, USA

    Andrea G. Edlow M.D., M.Sc.

Authors
  1. Deborah Bartz M.D., M.P.H.
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  2. M. Angela O’Neal M.D.
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  3. Andrea G. Edlow M.D., M.Sc.
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Corresponding author

Correspondence to Deborah Bartz M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

    Rebecca H. Allen

  2. Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA

    Carrie A. Cwiak

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Bartz, D., Angela O’Neal, M., Edlow, A.G. (2014). Contraceptive Options for Women with Headache Disease. In: Allen, R., Cwiak, C. (eds) Contraception for the Medically Challenging Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1233-9_7

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  • DOI: https://doi.org/10.1007/978-1-4939-1233-9_7

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