Vitali-Silva Aline, Vuolo Isabella G, Gonzalez Lara H, Galvão Renata F, Farges Silvia G, Bello Valéria A, Poli-Frederico Regina C
Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil.
Ir J Med Sci. 2023 Oct;192(5):2203-2208. doi: 10.1007/s11845-023-03293-x. Epub 2023 Feb 1.
For the most part, migraine afflicts young women who often need to use the hormonal contraceptive method.
To evaluate the effects of using exogenous estrogen, present in combined hormonal contraceptives (CHC) and progestin-only methods on the prevalence of allodynia in women with migraine.
Study comprising women diagnosed with migraine, with or without aura, who were not pregnant, breastfeeding, or menopausal. The study was conducted via the digital platform. Data were collected relating to demographics, contraceptive method, anthropometric information, smoking habits, and migraine-related symptoms. The participants then answered the following validated, self-administered questionnaires: Migraine Disability Assessment (MIDAS), Allodynia Symptom Checklist, Generalized Anxiety Disorder (GAD-7), and Beck's Depression Inventory (BDI). In order to determine the variables associated with allodynia, two binary logistic regression models were used.
Four hundred eighty-six women took part in the study. Of these, 205 used CHC, 89 used a progestin-only method, and 192 participants did not use any form of hormonal contraception. Allodynia was identified in 411 (84.6%) participants. Allodynia was linked to the presence of aura (OR = 2.76; CI 95% 1.55-4.91; p = 0.001), menstrually related migraine (OR = 2.14; CI 95% 1.28-3.57; p = 0.004), greater disability (MIDAS score 23 vs. 8; p < 0.001), depression (BDI score 14 vs. 10; p < 0.001), and anxiety (GAD-7 score 11 vs. 8; p < 0.001). In adjusted analysis, CHC was associated to protection against allodynia when jointly evaluated all CHC regimens (OR = 0.49 CI 95% 0.26-0.92; p = 0.028), as well as oral CHC individually (OR = 0.48 CI 95% 0.25-0.92; p = 0.027).
CHC reduced the chances of women with migraine getting allodynia.
在很大程度上，偏头痛困扰着年轻女性，她们常常需要使用激素避孕方法。
评估复方激素避孕药（CHC）和仅含孕激素方法中所含外源性雌激素对偏头痛女性中异常性疼痛患病率的影响。
该研究纳入了诊断为偏头痛的女性，无论有无先兆，且未怀孕、未哺乳或未绝经。研究通过数字平台进行。收集了有关人口统计学、避孕方法、人体测量信息、吸烟习惯和偏头痛相关症状的数据。参与者随后回答了以下经过验证的自我管理问卷：偏头痛残疾评估量表（MIDAS）、异常性疼痛症状清单、广泛性焦虑障碍量表（GAD - 7）和贝克抑郁量表（BDI）。为了确定与异常性疼痛相关的变量，使用了两个二元逻辑回归模型。
486名女性参与了该研究。其中，205人使用CHC，89人使用仅含孕激素的方法，192名参与者未使用任何形式的激素避孕。411名（84.6%）参与者被确定存在异常性疼痛。异常性疼痛与先兆的存在（比值比[OR] = 2.76；95%置信区间[CI] 1.55 - 4.91；p = 0.001）、月经相关偏头痛（OR = 2.14；95% CI 1.28 - 3.57；p = 0.004）、更大的残疾程度（MIDAS评分23 vs. 8；p < 0.001）、抑郁（BDI评分14 vs. 10；p < 0.001）和焦虑（GAD - 7评分11 vs. 8；p < 0.001）相关。在调整分析中，当联合评估所有CHC方案时，CHC与预防异常性疼痛相关（OR = 0.49，95% CI 0.26 - 0.92；p = 0.028），单独口服CHC时也是如此（OR = 0.48，95% CI 0.25 - 0.92；p = 0.027）。
CHC降低了偏头痛女性发生异常性疼痛的几率。
