Fitzek Mira P, Storch Elisabeth, Overeem Lucas H, Kull Pia, Terhart Maria, Lange Kristin S, Reuter Uwe, Raffaelli Bianca
Department of Neurology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
Universitätsmedizin Greifswald, 17489 Greifswald, Germany.
J Clin Med. 2023 Feb 10;12(4):1434. doi: 10.3390/jcm12041434.
Hormonal contraception (HC) can influence the migraine burden and should be considered in the comprehensive management of women with migraine. In this study, we aim to investigate the influence of migraine and migraine aura on the prescribing behavior of combined oral contraception (COC) and progestogen monotherapy (PM) in gynecological outpatient care. From October 2021 to March 2022, we performed an observational, cross-sectional study using a self-administered online-based survey. The questionnaire was distributed by mail and e-mail among 11,834 practicing gynecologists in Germany using the publicly available contact information. A total of 851 gynecologists responded to the questionnaire, of whom 12% never prescribe COC in the presence of migraine. Further 75% prescribe COC depending on the presence of limiting factors such as cardiovascular risk factors and comorbidities. When deciding to start PM, migraine appears to be less relevant, as 82% prescribe PM without restrictions. In the presence of aura, 90% of gynecologists do not prescribe COC at all, while PM is prescribed in 53% without restrictions. Almost all gynecologists reported to be actively involved in migraine therapy by having already initiated (80%), discontinued (96%), or changed (99%) HC due to migraine. Our results reveal that participating gynecologists actively consider migraine and migraine aura before and while prescribing HC. Gynecologists appear cautious in prescribing HC in patients with migraine aura.
激素避孕（HC）会影响偏头痛负担，在偏头痛女性的综合管理中应予以考虑。在本研究中，我们旨在调查偏头痛和偏头痛先兆对妇科门诊联合口服避孕药（COC）和孕激素单一疗法（PM）处方行为的影响。2021年10月至2022年3月，我们使用基于网络自行填写的调查问卷进行了一项观察性横断面研究。通过邮件和电子邮件，利用公开的联系信息，向德国11834名执业妇科医生发放了问卷.共有851名妇科医生回复了问卷，其中12%在患者有偏头痛时从不开具COC。另有75%的医生根据心血管危险因素和合并症等限制因素来决定是否开具COC。在决定开始使用PM时，偏头痛似乎相关性较小，因为82% 的医生无限制地开具PM。在有先兆的情况下，90%的妇科医生根本不开具COC，而53%的医生无限制地开具PM。几乎所有妇科医生都报告称，由于偏头痛，他们已经开始（80%）、停用（96%）或更改（99%）过HC，从而积极参与了偏头痛治疗。我们的结果显示，参与研究的妇科医生在开具HC之前和过程中会积极考虑偏头痛和偏头痛先兆。妇科医生在给有偏头痛先兆的患者开具HC时似乎较为谨慎。
