Allais Gianni, Castagnoli Gabellari Ilaria, De Lorenzo Cristina, Mana Ornella, Benedetto Chiara
University of Turin, Women's Headache Center, Department of Gynecology & Obstetrics, Via Ventimiglia 3, I-10126 Turin, Italy.
Expert Rev Neurother. 2007 Sep;7(9):1105-20. doi: 10.1586/14737175.7.9.1105.
Estrogens fluctuations, particularly their premenstrual fall, are currently regarded as the main triggers of menstrual migraine (MM). MM presents in two clinical forms: pure MM, where attacks are confined to the perimenstrual period (PMP), and menstrually related migraine, where attacks always occur during, but are not confined to, the PMP. MM episodes are usually longer, more intense, more disabling and more refractory than nonmenstrual attacks. Acute management of MM should initially be abortive and primarily sought with triptans. If this fails, short-term perimenstrual prophylaxis with NSAIDs, coxibs, triptans or ergotamine derivatives can be considered. Hormone manipulations, mainly application of percutaneous estradiol gel in PMP or administration of oral contraceptives in extended cycles, constitute an alternative approach for nonresponders.
雌激素波动，尤其是经前雌激素水平下降，目前被认为是月经性偏头痛（MM）的主要触发因素。MM有两种临床形式：纯MM，发作仅限于围经期（PMP）；月经相关性偏头痛，发作总是发生在PMP期间，但不限于该时期。MM发作通常比非经期发作持续时间更长、更剧烈、更致残且更难治疗。MM的急性治疗最初应以中止发作为目的，主要使用曲坦类药物。如果失败，可以考虑在围经期短期使用非甾体抗炎药、环氧化酶-2抑制剂、曲坦类药物或麦角胺衍生物进行预防。激素调节，主要是在PMP期间使用经皮雌二醇凝胶或延长周期服用口服避孕药，是对治疗无反应者的一种替代方法。
