Hormonal Contraception and Hormone Replacement Therapy in People with Headache

Reference work entry


The International Headache Society (IHS) classifies estrogen-withdrawal headache and exogenous hormone-induced headache. These events can occur as a result of use of hormonal contraceptives and hormone replacement therapy (HRT). Hormonal contraception, particularly combined hormonal contraceptives, is a popular and effective method, with additional non-contraceptive benefits. Combined hormonal contraceptives (CHCs) typically contain synthetic ethinylestradiol. This is more potent than natural estrogen and, coupled with progestogen, inhibits ovulation, thus providing contraceptive efficacy. For many women, migraine improves or they report change in migraine frequency or severity. Migraine without aura during the hormone-free interval is often the result of estrogen “withdrawal.” This can be treated with extended cycle or continuous combined hormonal contraceptives. Migraine with aura is an independent risk factor for ischemic stroke. Additional risk factors, including use of CHCs, further increase risk although the absolute risk of ischemic stroke in young women is low. Several progestogen-only and nonhormonal methods are more effective contraceptive options and are not associated with increased risk of ischemic stroke. On this basis, most authorities consider migraine with aura to be a contraindication to use of CHCs.

Hormone replacement therapy (HRT), although declining in popularity following uncertainty regarding long-term risk versus benefit, is the most effective treatment for moderate-to-severe vasomotor symptoms associated with menopause. HRT uses natural estrogens to supplement or replace ovarian estrogen at levels compatible with mean levels across the menstrual cycle. Doses are usually insufficient to suppress the natural ovarian cycle but sufficiently stabilize the perimenopausal fluctuations that are associated with vasomotor symptoms. Migraine aura is not a contraindication to use of HRT, as HRT does not appear to increase ischemic stroke risk if used for short-term treatment of vasomotor symptoms during the perimenopause. However, current use of HRT has an adverse effect on migraine frequency. Non-oral routes are recommended for women with migraine as these are less likely to have a negative effect on migraine than oral formulations. Further, continuous combined regimes appear to be better tolerated than cyclical combined HRT.


Ischemic Stroke Hormone Replacement Therapy Migraine With Aura Migraine Without Aura Hormonal Contraceptive 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Aegidius K, Zwart JA, Hagen K, Schei B, Stovner LJ (2006) Oral contraceptives and increased headache prevalence: the Head-HUNT study. Neurology 66:349–353PubMedCrossRefGoogle Scholar
  2. Aegidius KL, Zwart JA, Hagen K, Schei B, Stovner LJ (2007) Hormone replacement therapy and headache prevalence in postmenopausal women. The Head-HUNT study. Eur J Neurol 14:73–78PubMedCrossRefGoogle Scholar
  3. American College of Obstetricians and Gynecologists (2006) ACOG practice bulletin. No. 73: use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 107:1453–1472CrossRefGoogle Scholar
  4. Archer DF (2006) Menstrual-cycle-related symptoms: a review of the rationale for continuous use of oral contraceptives. Contraception 74:359–366PubMedCrossRefGoogle Scholar
  5. Berendsen HH (2000) The role of serotonin in hot flushes. Maturitas 36:155–164PubMedCrossRefGoogle Scholar
  6. Bigal M, Kurth T, Santanello N, Buse D, Golden W, Robbins M, Lipton R (2010) Migraine and cardiovascular disease: a population-based study. Neurology 74:628–635PubMedCrossRefGoogle Scholar
  7. Brill K, Schnitker J, Albring M (1990) Long-term experience with a low-dose oral contraceptive. Gynecol Endocrinol 4:277–286PubMedCrossRefGoogle Scholar
  8. Brosnan JF, Sheppard BL, Norris LA (2007) Haemostatic activation in post-menopausal women taking low-dose hormone therapy: less effect with transdermal administration? Thromb Haemost 97:558–565PubMedGoogle Scholar
  9. Calhoun AH (2004) A novel specific prophylaxis for menstrual-associated migraine. South Med J 97:819–822PubMedCrossRefGoogle Scholar
  10. Carolei A, Marini C, De Matteis G (1996) History of migraine and risk of cerebral ischaemia in young adults. The Italian National Research Council study group on stroke in the young. Lancet 347:1503–1506PubMedGoogle Scholar
  11. Chan WS, Ray J, Wai EK, Ginsburg S, Hannah ME, Corey PN, Ginsberg JS (2004) Risk of stroke in women exposed to low-dose oral contraceptives: a critical evaluation of the evidence. Arch Intern Med 164:741–747PubMedCrossRefGoogle Scholar
  12. Chang C, Donaghy M, Poulter N, World Health Organisation Collaboration Study of Cardiovascular Disease and Steroid Hormone Contraception (1999a) Migraine and stroke in young women: case-control study. Br Med J 318:13–18Google Scholar
  13. Chang CL, Donaghy M, Poulter N (1999b) Migraine and stroke in young women: case-control study. The World Health Organisation Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Br Med J 318:13–18Google Scholar
  14. Chumnijaraki T, Sunyavivat S, Onthuam Y, Udomprasetgurl V (1984) Study on the factors associated with contraception discontinuation in Bangkok. Contraception 29:241–248CrossRefGoogle Scholar
  15. Collaborative Group for the Study of Stroke in Young Women (1975) Oral contraceptives and stroke in young women. Associated risk factors. JAMA 231:718–722CrossRefGoogle Scholar
  16. Crassard I, Conard J, Bousser MG (2001) Migraine and haemostasis. Cephalalgia 21:630–636PubMedCrossRefGoogle Scholar
  17. Cullberg J (1972) Mood changes and menstrual symptoms with different gestagen/estrogen combinations. A double blind comparison with a placebo. Acta Psychiatr Scand Suppl 236:1–86PubMedGoogle Scholar
  18. Cupini LM, Matteis M, Troisi E, Calabresi P, Bernardi G, Silvestrini M (1995) Sex-hormone-related events in migrainous females. A clinical comparative study between migraine with aura and migraine without aura. Cephalalgia 15:140–144PubMedCrossRefGoogle Scholar
  19. Dalton K (1976) Migraine and oral contraceptives. Headache 15:247–251PubMedCrossRefGoogle Scholar
  20. Davies P, Fursdon-Davies C, Rees MC (2003) Progestogens for menstrual migraine. J Br Menopause Soc 9:134PubMedGoogle Scholar
  21. 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 (2002) Duration, frequency, recency, and type of migraine and risk of ischaemic stroke in women of childbearing age. J Neurol Neurosurg Psychiat 73:747–750PubMedCrossRefGoogle Scholar
  22. Dunson TR, McLaurin VL, Israngkura B, Leelapattana B, Mukherjee R, Perez-Palacios G, Saleh AA (1993) A comparative study of two low-dose combined oral contraceptives: results from a multicenter trial. Contraception 48:109–119PubMedCrossRefGoogle Scholar
  23. Edelman A, Gallo MF, Nichols MD, Jensen JT, Schulz KF, Grimes DA (2006) Continuous versus cyclic use of combined oral contraceptives for contraception: systematic Cochrane review of randomized controlled trials. Hum Reprod 21:573–578PubMedCrossRefGoogle Scholar
  24. Eilertsen AL, Qvigstad E, Andersen TO, Sandvik L, Sandset PM (2006) Conventional-dose hormone therapy (HT) and tibolone, but not low-dose HT and raloxifene, increase markers of activated coagulation. Maturitas 55:278–287PubMedCrossRefGoogle Scholar
  25. Ernst U, Baumgartner L, Bauer U, Janssen G (2002) Improvement of quality of life in women using a low-dose desogestrel-containing contraceptive: results of an observational clinical evaluation. Eur J Contracept Reprod Health Care 7:238–243PubMedGoogle Scholar
  26. Etminan M, Takkouche B, Isorna FC, Samii A (2005) Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. Br Med J 330:63–65CrossRefGoogle Scholar
  27. Facchinetti F, Nappi RE, Tirelli A, Polatti F, Nappi G, Sances G (2002) Hormone supplementation differently affects migraine in postmenopausal women. Headache 42:924–929PubMedCrossRefGoogle Scholar
  28. Faculty of Sexual and Reproductive Healthcare (2009) UK Medical Eligibility Criteria for Contraceptive Use (UKMEC 2009). http://www.fsrh.org
  29. Fait T, Vrablik M, Zizka Z, Kostirova M (2008) Changes in hemostatic variables induced by estrogen replacement therapy: comparison of transdermal and oral administration in a crossover-designed study. Gynecol Obstet Invest 65:47–51PubMedCrossRefGoogle Scholar
  30. Fotherby K (1992) Clinical experience and pharmacological effects of an oral contraceptive containing 20 micrograms oestrogen. Contraception 46:477–488PubMedCrossRefGoogle Scholar
  31. Fotherby K (1995) Twelve years of clinical experience with an oral contraceptive containing 30 micrograms ethinyloestradiol and 150 micrograms desogestrel. Contraception 51:3–12PubMedCrossRefGoogle Scholar
  32. Gillum LA, Mamidipudi SK, Johnston SC (2000) Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA 284:72–78PubMedCrossRefGoogle Scholar
  33. Granella F, Sances G, Zanferrari C, Costa A, Martignoni E, Manzoni GC (1993) Migraine without aura and reproductive life events: a clinical epidemiological study in 1,300 women. Headache 33:385–389PubMedCrossRefGoogle Scholar
  34. Granella F, Sances G, Pucci E, Nappi RE, Ghiotto N, Napp G (2000) Migraine with aura and reproductive life events: a case control study. Cephalalgia 20:701–707PubMedGoogle Scholar
  35. Headache Classification Subcommittee of the International Headache Society (IHS) (2004) The international classification of headache disorders (2nd edn). Cephalalgia 24:1–160Google Scholar
  36. Heinemann LA, Assmann A, DoMinh T, Garbe E (1999) Oral progestogen-only contraceptives and cardiovascular risk: results from the Transnational study on oral contraceptives and the health of young women. Eur J Contracept Reprod Health Care 4:67–73PubMedCrossRefGoogle Scholar
  37. Henrich JB, Horwitz LA (1989) A controlled study of ischemic stroke risk in migraine patients. J Clin Epidemiol 42:773–780PubMedCrossRefGoogle Scholar
  38. Hodson J, Thompson J, al-Azzawi F (2000) Headache at menopause and in hormone replacement therapy users. Climacteric 3:119–124PubMedCrossRefGoogle Scholar
  39. Horowski R, Runge I (1986) Possible role of gonadal hormones as triggering factors in migraine. Funct Neurol 1:405–414PubMedGoogle Scholar
  40. Kaiser HJ, Meienberg O (1993) Deterioration of onset of migraine under oestrogen replacement therapy in the menopause. J Neurol Neurosurg Psychiatry 240:195–197Google Scholar
  41. Kemmeren JM, Tanis BC, van den Bosch MA, Bollen EL, Helmerhorst FM, van der Graaf Y, Rosendaal FR, Algra A (2002) Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke. Stroke 33:1202–1208PubMedCrossRefGoogle Scholar
  42. Koetsawang S, Charoenvisal C, Banharnsupawat L, Singhakovin S, Kaewsuk O, Punnahitanont S (1995) Multicenter trial of two monophasic oral contraceptives containing 30 mcg ethinylestradiol and either desogestrel or gestodene in Thai women. Contraception 51:225–229PubMedCrossRefGoogle Scholar
  43. Kruit MC, van Buchem MA, Hofman PAM, Bakkers JTN, Terwindt GM, Ferrari MD, Launer LJ (2004) Migraine as a risk factor for subclinical brain lesions. JAMA 291:427–434PubMedCrossRefGoogle Scholar
  44. Kudrow L (1975) The relationship of headache frequency to hormone use in migraine. Headache 15:36–40PubMedCrossRefGoogle Scholar
  45. Kurth T, Slomke MA, Kase CS, Cook NR, Lee IM, Gaziano JM, Diener HC, Buring JE (2005) Migraine, headache, and the risk of stroke in women: a prospective study. Neurology 64:1020–1026PubMedCrossRefGoogle Scholar
  46. Kurth T, Gaziano JM, Cook NR, Logroscino G, Diener H-C, Buring JE (2006) Migraine and risk of cardiovascular disease in women. JAMA 296:283–291PubMedCrossRefGoogle Scholar
  47. Kurth T, Schurks M, Logroscino G, Gaziano JM, Buring JE (2008) Migraine, vascular risk, and cardiovascular events in women: prospective cohort study. Br Med J 337:a636CrossRefGoogle Scholar
  48. Kurth T, Schurks M, Logroscino G, Buring JE (2009) Migraine frequency and risk of cardiovascular disease in women. Neurology 73:581–588PubMedCrossRefGoogle Scholar
  49. LaGuardia KD, Fisher AC, Bainbridge JD, LoCoco JM, Friedman AJ (2005) Suppression of estrogen-withdrawal headache with extended transdermal contraception. Fertil Steril 83:1875–1877PubMedCrossRefGoogle Scholar
  50. Larsson-Cohn U, Lundberg PO (1970) Headache and treatment with oral contraceptives. Acta Neurol Scand 46:267–278PubMedCrossRefGoogle Scholar
  51. Lidegaard O (1993) Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study. Br Med J 306:956–963CrossRefGoogle Scholar
  52. Lidegaard Ø (1995) Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease. Br J Obstet Gynaecol 102:153–159PubMedCrossRefGoogle Scholar
  53. Lidegaard O, Kreiner S (2002) Contraceptives and cerebral thrombosis: a five-year national case-control study. Contraception 65:197–205PubMedCrossRefGoogle Scholar
  54. Luyer MD, Khosla S, Owen WG, Miller VM (2001) Prospective randomized study of effects of unopposed estrogen replacement therapy on markers of coagulation and inflammation in postmenopausal women. J Clin Endocrinol Metab 86:3629–3634PubMedCrossRefGoogle Scholar
  55. MacClellan LR, Giles W, Cole J, Wozniak M, Stern B, Mitchell BD, Kittner SJ (2007) Probable migraine with visual aura and risk of ischemic stroke. The stroke prevention in young women study. Stroke 38:2438–2445PubMedCrossRefGoogle Scholar
  56. MacGregor A (1999a) Estrogen replacement and migraine aura. Headache 39:674–678PubMedCrossRefGoogle Scholar
  57. MacGregor A (1999b) Effects of oral and transdermal estrogen replacement on migraine. Cephalalgia 19:124–125PubMedCrossRefGoogle Scholar
  58. MacGregor EA (2007) Migraine and use of combined hormonal contraceptives: a clinical review. J Fam Plann Reprod Health Care 33:159–169PubMedCrossRefGoogle Scholar
  59. MacGregor EA, Guillebaud J (1998) Combined oral contraceptives, migraine and ischaemic stroke. Clinical and Scientific Committee of the Faculty of Family Planning and Reproductive Health Care and the Family Planning Association. Br J Fam Plann 24:55–60PubMedGoogle Scholar
  60. MacGregor EA, Hackshaw A (2002) 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 28:27–31PubMedCrossRefGoogle Scholar
  61. MacGregor EA, Frith A, Ellis J, Aspinall L, Hackshaw A (2006) Incidence of migraine relative to menstrual cycle phases of rising and falling estrogen. Neurology 67:2154–2158PubMedCrossRefGoogle Scholar
  62. Machado RB, Pereira AP, Coelho GP, Neri L, Martins L, Luminoso D (2010) Epidemiological and clinical aspects of migraine in users of combined oral contraceptives. Contraception 81(3):202–208PubMedCrossRefGoogle Scholar
  63. Martinelli I, Battaglioli T, Burgo I, Di Domenico S, Mannucci PM (2006) Oral contraceptive use, thrombophilia and their interaction in young women with ischemic stroke. Haematologica 91:844–847PubMedGoogle Scholar
  64. Mendelsohn ME (2002) Protective effects of estrogen on the cardiovascular system. Am J Cardiol 89:12E–17E, discussion 17E–18EPubMedCrossRefGoogle Scholar
  65. Misakian AL, Langer RD, Bensenor IM, Cook NR, Manson JE, Buring JE, Rexrode KM (2003) Postmenopausal hormone therapy and migraine headache. J Womens Health Larchmt 12:1027–1036PubMedCrossRefGoogle Scholar
  66. Moorhead T, Hannaford P, Warskyj M (1997) Prevalence and characteristics associated with use of hormone replacement therapy in Britain. Br J Obstet Gynaecol 104:290–297PubMedCrossRefGoogle Scholar
  67. Moschiano F, D’Amico D, Ciusani E, Erba N, Rigamonti A, Schieroni F, Bussone G (2004) Coagulation abnormalities in migraine and ischaemic cerebrovascular disease: a link between migraine and ischaemic stroke? Neurol Sci 25(suppl 3):S126–S128PubMedCrossRefGoogle Scholar
  68. Mueller L (2000) Predictability of exogenous hormone effect on subgroups of migraineurs. Headache 40:189–193PubMedCrossRefGoogle Scholar
  69. Nappi RE, Cagnacci A, Granella F, Piccinini F, Polatti F, Facchinetti F (2001) Course of primary headaches during hormone replacement therapy. Maturitas 38:157–163PubMedCrossRefGoogle Scholar
  70. Nappi RE, Sances G, Sommacal A, Detaddei S, Facchinetti F, Cristina S, Polatti F, Nappi G (2006) Different effects of tibolone and low-dose EPT in the management of postmenopausal women with primary headaches. Menopause 13:818–825PubMedCrossRefGoogle Scholar
  71. Nightingale AL, Farmer RD (2004) Ischemic stroke in young women: a nested case-control study using the UK General Practice Research Database. Stroke 35:1574–1578PubMedCrossRefGoogle Scholar
  72. North American Menopause Society (2004) Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Menopause 11:11–33CrossRefGoogle Scholar
  73. North American Menopause Society (2010) Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause 17(2):242–255CrossRefGoogle Scholar
  74. Petitti DB, Sidney S, Bernstein A, Wolf S, Quesenberry C, Ziel HK (1996) Stroke in users of low-dose oral contraceptives. N Engl J Med 335:8–15PubMedCrossRefGoogle Scholar
  75. Phillips BM (1968) Oral contraceptive drugs and migraine. Br Med J 2:99PubMedCrossRefGoogle Scholar
  76. Poulter NR, Chang CL, Farley TM, Meirik O (1999) Risk of cardiovascular diseases associated with oral progestagen preparations with therapeutic indications. Lancet 354:1610PubMedCrossRefGoogle Scholar
  77. Rodstrom K, Bengtsson C, Lissner L, Milsom I, Sundh V, Bjorkelund C (2002) A longitudinal study of the treatment of hot flushes: the population study of women in Gothenburg during a quarter of a century. Menopause 9:156–161PubMedCrossRefGoogle Scholar
  78. Rubino E, Ferrero M, Rainero I, Binello E, Vaula G, Pinessi L (2009) Association of the C677T polymorphism in the MTHFR gene with migraine: a meta-analysis. Cephalalgia 29:818–825PubMedCrossRefGoogle Scholar
  79. Ryan RE (1978) A controlled study of the effect of oral contraceptives on migraine. Headache 17:250–252PubMedCrossRefGoogle Scholar
  80. Scher AI, Terwindt GM, Picavet HS, Verschuren WM, Ferrari MD, Launer LJ (2005) Cardiovascular risk factors and migraine: the GEM population-based study. Neurology 64:614–620PubMedCrossRefGoogle Scholar
  81. Scher AI, Terwindt GM, Verschuren WM, Kruit MC, Blom HJ, Kowa H, Frants RR, van den Maagdenberg AM, van Buchem M, Ferrari MD, Launer LJ (2006) Migraine and MTHFR C677T genotype in a population-based sample. Ann Neurol 59:372–375PubMedCrossRefGoogle Scholar
  82. Schurks M, Zee RY, Buring JE, Kurth T (2008) Interrelationships among the MTHFR 677C > T polymorphism, migraine, and cardiovascular disease. Neurology 71:505–513PubMedCrossRefGoogle Scholar
  83. Schurks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T (2009) Migraine and cardiovascular disease: systematic review and meta-analysis. Br Med J 339:b3914CrossRefGoogle Scholar
  84. Schwaag S, Nabavi DG, Frese A, Husstedt IW, Evers S (2003) The association between migraine and juvenile stroke: a case-control study. Headache 43:90–95PubMedCrossRefGoogle Scholar
  85. Schwaiger J, Kiechl S, Stockner H, Knoflach M, Werner P, Rungger G, Gasperi A, Willeit J (2008) Burden of atherosclerosis and risk of venous thromboembolism in patients with migraine. Neurology 71:937–943PubMedCrossRefGoogle Scholar
  86. Schwartz SM, Petitti DB, Siscovick DS, Longstreth WT Jr, Sidney S, Raghunathan TE, Quesenberry CP Jr, Kelaghan J (1998) Stroke and use of low-dose oral contraceptives in young women. A pooled analysis of two studies. Stroke 29:2277–2284PubMedCrossRefGoogle Scholar
  87. Siritho S, Thrift AG, McNeil JJ, You RX, Davis SM, Donnan GA (2003) Risk of ischemic stroke among users of the oral contraceptive pill: The Melbourne Risk Factor Study (MERFS) Group. Stroke 34:1575–1580PubMedCrossRefGoogle Scholar
  88. Sluglett J, Lawson JP (1967) Side-effects of oral contraceptives. Lancet 2:612PubMedCrossRefGoogle Scholar
  89. Stang PE, Carson AP, Rose KM, Mo J, Ephross SA, Shahar E, Szklo M (2005) Headache, cerebrovascular symptoms, and stroke: the atherosclerosis risk in communities study. Neurology 64:1573–1577PubMedCrossRefGoogle Scholar
  90. Sulak P, Scow R, Preece C, Riggs M, Kuehl T (2000) Hormone withdrawal symptoms in oral contraceptive users. Obstet Gynecol 95:261–266PubMedCrossRefGoogle Scholar
  91. Sulak PJ, Kuehl TJ, Ortiz M, Shull BL (2002) Acceptance of altering the standard 21-day/7-day oral contraceptive regimen to delay menses and reduce hormone withdrawal symptoms. Am J Obstet Gynecol 186:1142–1149PubMedCrossRefGoogle Scholar
  92. Sulak P, Willis S, Kuehl T, Coffee A, Clark J (2007) Headaches and oral contraceptives: impact of eliminating the standard 7-day placebo interval. Headache 47:27–37PubMedGoogle Scholar
  93. The American College of Obstetricians and Gynecologists (2010) Noncontraceptive uses of hormonal contraception. Obstet Gynecol 115:206–218CrossRefGoogle Scholar
  94. Tzourio C, Iglesias S, Hubert JB, Visy JM, Alperovitch A, Tehindrazanarivelo A, Biousse V, Woimant F, Bousser MG (1993) Migraine and risk of ischaemic stroke: a case-control study. Br Med J 307:289–292CrossRefGoogle Scholar
  95. Tzourio C, Tehindrazanarivelo A, Iglesias S, Alperovitch A, Chedru F, d’Anglejan-Chatillon J, Bousser MG (1995) Case-control study of migraine and risk of ischaemic stroke in young women. Br Med J 310:830–833Google Scholar
  96. Warren MP, Kulak J Jr (1998) Is estrogen replacement indicated in perimenopausal women? Clin Obstet Gynecol 41:976–987PubMedCrossRefGoogle Scholar
  97. Whitty CW, Hockaday JM, Whitty MM (1966) The effect of oral contraceptives on migraine. Lancet i:856–859CrossRefGoogle Scholar
  98. World Health Organization (2009) Medical eligibility criteria for contraceptive use. WHO, GenevaGoogle Scholar
  99. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception (1996a) Ischaemic stroke and combined oral contraceptives; results of an international, multicentre, case-control study. Lancet 348:498–505CrossRefGoogle Scholar
  100. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception (1996b) Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study. Lancet 348:505–510CrossRefGoogle Scholar
  101. Zegura B, Guzic-Salobir B, Sebestjen M, Keber I (2006) The effect of various menopausal hormone therapies on markers of inflammation, coagulation, fibrinolysis, lipids, and lipoproteins in healthy postmenopausal women. Menopause 13:643–650PubMedCrossRefGoogle Scholar

Copyright information

© Lifting The Burden 2011

Authors and Affiliations

  1. 1.The City of London Migraine ClinicLondonUK
  2. 2.Regionales Schmerzzentrum EssenEssenGermany

Personalised recommendations