Allais G, Bussone G, De Lorenzo C, Mana O, Benedetto C
Woman's Headache Center, Department of Gynecology and Obstetrics, University of Turin, Via Ventimiglia 3, I-10126, Turin, Italy.
Neurol Sci. 2005 May;26 Suppl 2:s125-9. doi: 10.1007/s10072-005-0424-7.
Patients suffering from menstrual migraine (MM) may be ideal candidates for an intermittent prophylaxis, usually termed short-term or mini-prophylaxis. It covers the whole period of vulnerability, e. g., the perimenstrual period, starting some days before the expected onset of MM attack. Theoretically MM attacks are an optimal target for drugs specifically developed for acute head pain. Unfortunately, due to their particular tendency to be longer, more intense and less responsive to analgesics, symptomatic approaches alone are not often able to completely control pain and its correlates. Many drugs have been proposed for short-term prophylaxis of MM. In this paper we analyse only non-steroidal anti-inflammatory drugs, coxibs and triptans (especially those with longer half-life, naratriptan and frovatriptan). Moreover, MM can be prevented by a variety of hormonal manipulations, including oral contraceptives, which may be administered with an extended-dosing strategy; oestrogen replacement therapy; antioestrogen agents (danazol, tamoxifen); gonadotropin-releasing hormone agonists followed by oestrogen add-back therapy. Finally, the use of some products, such as magnesium and phytoestrogens, that probably meet the requirements of those patients that appreciate a more "natural" approach, is discussed.
患有月经性偏头痛（MM）的患者可能是间歇性预防治疗的理想人选，这种治疗通常称为短期或小剂量预防。它涵盖了整个易发病期，例如，月经周期，从预计MM发作开始前几天开始。从理论上讲，MM发作是专门为急性头痛开发的药物的最佳靶点。不幸的是，由于MM发作往往持续时间更长、疼痛更剧烈且对镇痛药反应较差，仅采用对症治疗方法往往无法完全控制疼痛及其相关症状。已经提出了许多药物用于MM的短期预防。在本文中，我们仅分析非甾体抗炎药、环氧化酶-2抑制剂和曲坦类药物（特别是那些半衰期较长的药物，那拉曲坦和夫罗曲坦）。此外，MM可以通过多种激素治疗方法预防，包括口服避孕药，可采用延长给药策略；雌激素替代疗法；抗雌激素药物（达那唑、他莫昔芬）；促性腺激素释放激素激动剂随后进行雌激素补充疗法。最后，还讨论了一些产品的使用，如镁和植物雌激素，这些产品可能符合那些倾向于采用更“天然”方法的患者的需求。
