Merki-Feld Gabriele S, Imthurn Bruno, Seifert Burkhardt, Merki Laura L, Agosti Reto, Gantenbein Andreas R
* Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics, University Hospital Zürich , Switzerland.
Eur J Contracept Reprod Health Care. 2013 Oct;18(5):394-400. doi: 10.3109/13625187.2013.814769. Epub 2013 Aug 9.
To analyse the effects of a three-month course of progestogen-only contraception with desogestrel 75 μg on disability, headache frequency and headache intensity in migraineurs.
Migraine disability headache questionnaires (MIDAS) were collected from 37 migraineurs during counselling, and at the end of three months treatment with desogestrel. Another ten women initiated but did not complete treatment. They are included in the overall evaluations of the effect of the regimen on migraine status.
Desogestrel was associated with significant reductions in headache days and intensity (p < 0.001; p < 0.006), and a significant improvement in quality of life. Days missed at work and days missing leisure activities diminished (p < 0.001; p < 0.001). The MIDAS migraine disability score improved significantly (from 27.4 to 11.1 points) (p < 0.001). While 25 of the 37 women (68%) experienced a decrease of at least one grade, this level of benefit cannot be extrapolated to all initiators. When dropouts are considered, MIDAS grades decrease in 53% (25/47) of the cases.
The majority of migraineurs experienced a clinically significant reduction in headache frequency and improvement of quality of life with use of desogestrel. Prospective randomised controlled trials are needed to substantiate our results.
分析为期三个月的仅含去氧孕烯75μg的孕激素避孕法对偏头痛患者的残疾情况、头痛频率和头痛强度的影响。
在咨询期间以及使用去氧孕烯治疗三个月结束时,从37名偏头痛患者处收集偏头痛残疾头痛问卷(MIDAS)。另外有10名女性开始治疗但未完成。她们被纳入该方案对偏头痛状态影响的总体评估中。
去氧孕烯与头痛天数和强度的显著降低相关(p<0.001;p<0.006),生活质量也有显著改善。工作缺勤天数和休闲活动缺失天数减少(p<0.001;p<0.001)。MIDAS偏头痛残疾评分显著改善(从27.4分降至11.1分)(p<0.001)。37名女性中有25名(68%)头痛等级至少降低了一级,但这种获益水平不能外推至所有开始治疗的患者。若将未完成治疗者考虑在内,MIDAS等级在53%(25/47)的病例中降低。
大多数偏头痛患者使用去氧孕烯后头痛频率在临床上显著降低,生活质量得到改善。需要进行前瞻性随机对照试验来证实我们的结果。