Allais Gianni, Chiarle Giulia, Sinigaglia Silvia, Airola Gisella, Schiapparelli Paola, Bergandi Fabiola, Benedetto Chiara
Department of Surgical Sciences, Women's Headache Center, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy.
Neurol Sci. 2017 May;38(Suppl 1):85-89. doi: 10.1007/s10072-017-2906-9.
At least 18% of women suffers from migraine. Clinically, there are two main forms of migraine: migraine with aura (MA) and migraine without aura (MO) and more than 50% of MO is strongly correlated to the menstrual cycle. The high prevalence of migraine in females, its correlation with the menstrual cycle and with the use of combined hormonal contraceptives (CHCs) suggest that the estrogen drop is implicated in the pathogenesis of the attacks. Although CHCs may trigger or worsen migraine, their correct use may even prevent or reduce some forms of migraine, like estrogen withdrawal headache. Evidence suggested that stable estrogen levels have a positive effect, minimising or eliminating the estrogenic drop. Several contraceptive strategies may act in this way: extended-cycle CHCs, CHCs with shortened hormone-free interval (HFI), progestogen-only contraceptives, CHCs containing new generation estrogens and estrogen supplementation during the HFI.
至少18%的女性患有偏头痛。临床上，偏头痛主要有两种形式：有先兆偏头痛（MA）和无先兆偏头痛（MO），且超过50%的无先兆偏头痛与月经周期密切相关。女性偏头痛的高患病率、其与月经周期以及与复方激素避孕药（CHCs）使用的相关性表明，雌激素下降与发作的发病机制有关。虽然复方激素避孕药可能引发或加重偏头痛，但正确使用它们甚至可以预防或减轻某些形式的偏头痛，如雌激素撤退性头痛。有证据表明，稳定的雌激素水平具有积极作用，可将雌激素下降降至最低或消除。几种避孕策略可能以这种方式起作用：延长周期复方激素避孕药、缩短无激素间隔（HFI）的复方激素避孕药、仅含孕激素的避孕药、含有新一代雌激素的复方激素避孕药以及在无激素间隔期间补充雌激素。
