Migraine and Use of Combined Hormonal Contraception

  • Francesca Pistoia
  • Simona SaccoEmail author
Part of the Headache book series (HEAD)


Migraine onset and activity in women are influenced by the fluctuations of sex hormone levels, particularly estrogen. According to the “estrogen withdrawal hypothesis,” migraine episodes are precipitated by a decline in estrogen, as may occur in the menstrual period [1]. Therefore, exogenous estrogens such as those contained in combined hormonal contraceptives (CHC) might interfere with the course of headache in women with migraine. In most cases, the use of CHC leads to an exacerbation or even a new onset of migraine, while in other cases, CHC can lead to an improvement or even be used as migraine prophylaxis (e.g., menstrual migraine [MM]). A complex and still unknown interaction between the vascular actions of estrogens and the vascular alterations of subjects with migraine may also explain the highly increased risk of cardiovascular events among women with migraine using CHC [2].


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Applied Clinical Sciences and BiotechnologyUniversity of L’AquilaL’AquilaItaly

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