Birth control pills migraine
The relationship of migraine with sexual hormones
The role of female sex hormones in the development of migraine confirms the fact that there is a direct relationship between the fluctuations of hormones in the blood of women and development of headaches. Allocate 2 types of migraine associated with a woman's cycle:
- True menstrual migraine is headaches that meet the criteria of migraine and occur exclusively in the period from two days before menstruation to 3 days of menstrual bleeding. The migraine should occur in 2 of 3 cycles and not developed in other periods.
- Migraine associated with menstruation – it's the headaches that meet the criteria of migraine and can occur before the menstruation and during other periods of the female cycle.
The exact cause of migraine is not established today, but it is known that in the formation of migraine attack there are three components: vascular, nervous and endocrine. It is with the latter and associated with the development of menstrual migraine. In some scientific papers it has been proven that increase estrogen reduces the frequency of migraine attacks without aura, but worsens the prognosis of migraine with aura. Thus, èstrogensoderžaŝimi COC can be used during a migraine with aura, but it is possible with simple type of the disease. Some women have even observed the improvement in the application of oral contraceptives.
In the late luteal and early follicular phase of the cycle (perimenstrually period) there is maximum reduction in estrogen, which leads to the development of headaches. The role of estrogen confirmed by the fact that very often the migraine attacks take place during pregnancy, when a woman's body there is a constant and stable concentration of estrogen hormones. If the migraine is exacerbated during pregnancy or occurs during the first, it can be argued that there is a migraine with an aura (the pathogenesis of which estrogens play a negative role).
Thus, the first thing you need to figure out if a woman with migraine wants to take oral contraceptives is what type of disease is present in this case. Depending on this, and the presence of other stroke risk factors and will get the type and composition of the pill, and it is possible that the specific patient the purpose of the COC is absolutely contraindicated and it is necessary to choose another form of contraception.
Principal of birth control pills
The composition of a combined oral contraceptive may enter 2 existing substances (synthetic analogues of natural hormones):
As the estrogen component inmodern tablets used ethinyl estradiol, and progesterone has been around for several generations, which are called progestins. As a rule, contain progestins modern COC 3rd and 4th generation.
Birth control pills differ mainly in the amount of estrogen (high-, low - and micro-dose), at the moment, high-dose, highly drugs are rare; referring to progestin, which is part of the tablets; on the stage motion (mono-, two - and three-phase), biphasic contraceptives is not widely applied. Also there are preparations that contain only progestins and do not have estrogen. They can be used when breast-feeding and the presence of contraindications to the use of the COC, which contain estrogen, for example, migraine with aura.
Impact of oral contraceptives on migraine course
Recent clinical studies show that the pill can cause the beginning of a migraine, and in the case of a previously existing disease can cause a worsening of its course, frequent migraine attacks, the development of tolerance to the drugs for the treatment of migraine.
But such an effect birth control pills have not always. This is due primarily to the fact that migraine is not one disease but a heterogeneous group of pathologies. For example, some women, conversely, feel relieved migraine attacks or their complete cessation in patients receiving combined oral contraceptives (COCs), and use these drugs as a prophylactic. Usually this phenomenon can be observed in migraine without aura. It is also important to consider the composition of tablets, because they are not all the same.
Migraine with aura is a completely different story. According to the latest statistics, this type of headache increases the risk of developing
Which method of contraception to choose a woman with migraine?
According to modern gynecological recommendations, the use of oestrogen-containing oral contraceptives for women with migraine, particularly with aura, is contraindicated. Preference should be given to barrier methods of contraception using IUDs or oral contraceptives based on progestogen.
As for the KOK, the algorithm of their application in migraine the following:
- The COC is absolutely contraindicated in cases where the health risk is much higher than the benefit from their use. This situation is observed in migraine with aura.
- The COC is relatively contraindicated in cases when the risk when the pill exceeds their favor. This situation is observed in migraine without aura if there is an additional risk factor for stroke (woman's age exceeds 35 years, the presence ofdiseases such as diabetes,
Oral contraceptives based on progestogen
Birth control pills on the basis of progestins can be used in patients with migraine (in some cases even in the presence of the aura). They are in their composition do not contain estrogen hormones, which are a factor in the pathogenesis of menstrual migraine. These drugs can be found under the name “mini-pill”.
They are indicated for the prevention of unwanted pregnancies in women after 40 years of age and in nursing mothers. Data contraceptive pill can be used by women with migraine who are contraindicated for combined pills with estrogen. The contraceptive effect of the mini-pill is slightly lower than COC, but drugs of the last generation are not inferior to them.
Video transmission about oral contraceptives:
The choice of drug for permanent contraception is a complex and serious task that should only doctor. Otherwise there is a high risk of side effects, up to the stroke.