Department of Gynecology and Obstetrics, Jundiaí School of Medicine, Jundiaí, São Paulo, Brazil.
Contraception. 2010 Mar;81(3):202-8. doi: 10.1016/j.contraception.2009.09.006. Epub 2009 Oct 28.
Migraine was assessed in users of combined oral contraceptives (COCs).
This study had a cross-sectional design. Women with headaches were evaluated according to International Headache Society criteria and subsequently allocated to a "migraine" or "non-migraine" group.
Migraine was detected in 80/480 women (16.6%), while other types of headache not classified as migraine were observed in 400 women (83.4%). Following COC use, headaches worsened in 32.5% and 19.3% [odds ratio (OR)=3.02; 95% confidence interval (CI)=1.68-5.4] and improved in 30% and 13.8% (OR=3.9; 95% CI=2.12-7.18) of the "migraine" and "non-migraine" groups, respectively. In the migraine group only, headache episodes occurred predominantly during or around the hormone-free interval (OR=2.05; 95% CI=1.26-3.35). The combination of ethinylestradiol (EE) and drospirenone (DRS) was significantly associated with an improvement in the frequency and/or intensity of migraine-type headaches, compared with other types of COCs.
The prevalence of migraine in COC users appears similar to that found in the general population. Migraines, but not other types of headache, were significantly affected by COCs. The EE/DRS combination was associated with a greater likelihood of improvement in migraine compared with other types of COCs.
评估了复方口服避孕药（COC）使用者的偏头痛情况。
本研究采用横断面设计。根据国际头痛协会标准评估有头痛的女性，随后将其分配到“偏头痛”或“非偏头痛”组。
在 480 名女性中发现偏头痛 80 例（16.6%），而其他未归类为偏头痛的头痛类型在 400 名女性中观察到 400 例（83.4%）。使用 COC 后，“偏头痛”和“非偏头痛”组分别有 32.5%和 19.3%（比值比[OR]=3.02；95%置信区间[CI]=1.68-5.4）的患者头痛加重，分别有 30%和 13.8%（OR=3.9；95% CI=2.12-7.18）的患者头痛改善。仅在偏头痛组中，头痛发作主要发生在无激素间隔期间或周围（OR=2.05；95% CI=1.26-3.35）。与其他类型的 COC 相比，炔雌醇（EE）和屈螺酮（DRS）的联合使用与偏头痛型头痛的频率和/或强度的改善显著相关。
COC 使用者中偏头痛的患病率似乎与普通人群相似。偏头痛，而不是其他类型的头痛，受 COC 的显著影响。与其他类型的 COC 相比，EE/DRS 联合使用更有可能改善偏头痛。
