Skip to main content
Log in

Hormonelle Kontrazeptiva bei menstrueller Migräne

Pathophysiologische Grundlagen und aktuelle Empfehlungen

  • Zertifizierte Fortbildung
  • Published:
Schmerzmedizin Aims and scope

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8 Suppl 7:1-96

  2. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9-160

  3. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders ICHD-3, 3rd edition. Cephalalgia. 2018;38(1):1-211

  4. Nappi RE et al. Role of Estrogens in Menstrual Migraine. Cells. 2022;11(8)

  5. Russell MB. Genetics of menstrual migraine: the epidemiological evidence. Curr Pain Headache Rep. 2010;14(5):385-8

  6. Somerville BW. The role of estradiol withdrawal in the etiology of menstrual migraine. Neurology. 1972;22(4):355-65

  7. Pavlović JM et al. Sex hormones in women with and without migraine. Neurology. 2016;87(1):49

  8. Cornil CA, Ball GF, Balthazart J. Functional significance of the rapid regulation of brain estrogen action: where do the estrogens come from? Brain Res. 2006;1126(1):2-26

  9. Boese AC et al. Sex differences in vascular physiology and pathophysiology: estrogen and androgen signaling in health and disease. Am J Physiol Heart Circ Physiol. 2017;313(3):H524-H545

  10. Rodriguez-Acevedo AJ et al. Genetic association and gene expression studies suggest that genetic variants in the SYNE1 and TNF genes are related to menstrual migraine. J Headache Pain. 2014;15(1):62

  11. Vetvik KG, MacGregor EA. Menstrual migraine: a distinct disorder needing greater recognition. Lancet Neurol. 2021;20(4):304-15

  12. Shughrue PJ, Merchenthaler I. Estrogen is more than just a "sex hormone": novel sites for estrogen action in the hippocampus and cerebral cortex. Front Neuroendocrinol. 2000;21(1):95-101

  13. Facchinetti F et al. Neuroendocrine evaluation of central opiate activity in primary headache disorders. Pain. 1988;34(1):29-33

  14. Tassorelli C et al. Changes in nociceptive flexion reflex threshold across the menstrual cycle in healthy women. Psychosom Med. 2002;64(4):621-6

  15. Krause DN et al. Hormonal influences in migraine - interactions of oestrogen, oxytocin and CGRP. Nat Rev Neurol. 2021;17(10):621-33

  16. De Icco R et al. Modulation of nociceptive threshold by combined hormonal contraceptives in women with oestrogen-withdrawal migraine attacks: a pilot study. J Headache Pain. 2016;17(1):70

  17. Warfvinge K et al. Estrogen receptors α, β and GPER in the CNS and trigeminal system - molecular and functional aspects. J Headache Pain. 2020;21(1):131

  18. Kitazawa T et al. Non-genomic mechanism of 17 beta-oestradiol-induced inhibition of contraction in mammalian vascular smooth muscle. J Physiol. 1997;499(Pt 2):497-511

  19. Somjen GG. Mechanisms of spreading depression and hypoxic spreading depression-like depolarization. Physiol Rev. 2001;81(3):1065-96

  20. Edvinsson L et al. CGRP as the target of new migraine therapies - successful translation from bench to clinic. Nat Rev Neurol. 2018;14(6):338-50

  21. Knight YE, Edvinsson L, Goadsby PJ. 4991W93 inhibits release of calcitonin gene-related peptide in the cat but only at doses with 5HT(1B/1D) receptor agonist activity? Neuropharmacology. 2001;40(4):520-5

  22. Ashina M. Migraine. N Engl J Med. 2020;383(19):1866-76

  23. Forbes RB, McCarron M, Cardwell CR. Efficacy and Contextual (Placebo) Effects of CGRP Antibodies for Migraine: Systematic Review and Meta-analysis. Headache. 2020;60(8):1542-57

  24. Drellia K et al. Anti-CGRP monoclonal antibodies for migraine prevention: A systematic review and likelihood to help or harm analysis. Cephalalgia. 2021;41(7):851-64

  25. Valdemarsson S et al. Hormonal influence on calcitonin gene-related peptide in man: effects of sex difference and contraceptive pills. Scand J Clin Lab Invest. 1990;50(4):385-8

  26. Gupta P et al. Effects of menopausal status on circulating calcitonin gene-related peptide and adipokines: implications for insulin resistance and cardiovascular risks. Climacteric. 2008;11(5):364-72

  27. Aggarwal M, Puri V, Puri S. Effects of estrogen on the serotonergic system and calcitonin gene-related peptide in trigeminal ganglia of rats. Ann Neurosci. 2012;19(4):151-7

  28. Cetinkaya A et al. Effects of estrogen and progesterone on the neurogenic inflammatory neuropeptides: implications for gender differences in migraine. Exp Brain Res. 2020;238(11): 2625-39

  29. Yamanaka G et al. Role of Neuroinflammation and Blood-Brain Barrier Permutability on Migraine. Int J Mol Sci. 2021;22(16)

  30. Cupini LM, Corbelli I, Sarchelli P. Menstrual migraine: what it is and does it matter? J Neurol. 2021;268(7):2355-63

  31. MacGregor EA et al. Incidence of migraine relative to menstrual cycle phases of rising and falling estrogen. Neurology. 2006;67(12):2154-8

  32. Sacco S et al. Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH). J Headache Pain. 2018;19(1):76

  33. Sacco S et al. Hormonal contraceptives and risk of ischemic stroke in women with migraine: a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC). J Headache Pain. 2017;18(1):108

  34. Merki-Feld GS et al. Improvement of migraine with change from combined hormonal contraceptives to progestin-only contraception with desogestrel: How strong is the effect of taking women off combined contraceptives? J Obstet Gynaecol. 2017;37(3):338-41

  35. Morotti M et al. Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura. Eur J Obstet Gynecol Reprod Biol. 2014;79:63-8

  36. Morotti M et al. Progestin-only contraception compared with extended combined oral contraceptive in women with migraine without aura: a retrospective pilot study. Eur J Obstet Gynecol Reprod Biol. 2014;183:178-82

  37. Nappi RE et al. Effects of an estrogen-free, desogestrel-containing oral contraceptive in women with migraine with aura: a prospective diary-based pilot study. Contraception. 2011;83(3):223-8

  38. Coffee AL et al. Extended cycle combined oral contraceptives and prophylactic frovatriptan during the hormone-free interval in women with menstrual-related migraines. J Womens Health (Larchmt). 2014;23(4):310-7

  39. Calhoun AH. A novel specific prophylaxis for menstrual-associated migraine. South Med J. 2004;97(9):819-22

  40. Macgregor EA, Hackshaw A. Prevention of migraine in the pill-free interval of combined oral contraceptives: a double-blind, placebo-controlled pilot study using natural oestrogen supplements. J Fam Plann Reprod Health Care. 2002;28(1):27-31

  41. LaGuardia KD et al. Suppression of estrogen-withdrawal headache with extended transdermal contraception. Fertil Steril. 2005;83(6):1875-7

  42. Calhoun A, Ford S, Pruitt A. The impact of extended-cycle vaginal ring contraception on migraine aura: a retrospective case series. Headache. 2012;52(8):1246-53

  43. de Lignières B et al. Prevention of menstrual migraine by percutaneous oestradiol. Br Med J (Clin Res Ed). 1986;293(6561):1540

  44. Dennerstein L et al. Menstrual migraine: a double-blind trial of percutaneous estradiol. Gynecol Endocrinol. 1988;2(2):113-20

  45. MacGregor EA et al. Prevention of menstrual attacks of migraine: a double-blind placebo-controlled crossover study. Neurology. 2006;67(12):2159-63

  46. Martin V et al. Medical oophorectomy with and without estrogen add-back therapy in the prevention of migraine headache. Headache. 2003;43(4):309-21

  47. Magos AL, Zilkha KJ, Studd JW. Treatment of menstrual migraine by oestradiol implants. J Neurol Neurosurg Psychiatry.1983;46(11):1044-6

  48. Murray SC, Muse KN. Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and "add-back" therapy. Fertil Steril. 1997;67(2):390-3

  49. Ferrante F et al. Phyto-oestrogens in the prophylaxis of menstrual migraine. Clin Neuropharmacol. 2004;27(3):137-40

  50. Burke BE, Olson RD, Cusack BJ. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother. 2002;56(6):283-8

  51. Eikermann-Haerter K. et al. Androgenic suppression of spreading depression in familial hemiplegic migraine type 1 mutant mice. Ann Neurol. 2009;66(4):564-8

  52. Nappi RE, Wawra K, Schmitt S. Hypoactive sexual desire disorder in postmenopausal women. Gynecol Endocrinol. 2006;22(6):318-23

  53. MacGregor EA. Menstrual and perimenopausal migraine: A narrative review. Maturitas. 2020;142:24-30

  54. Schoretsanitis G et al. Drug-drug interactions between psychotropic medications and oral contraceptives. Expert Opin Drug Metab Toxicol. 2022;18(6):395-411

  55. Lazorwitz A et al. Effect of Topiramate on Serum Etonogestrel Concentrations Among Contraceptive Implant Users. Obstet Gynecol. 2022;139(4):579-87

  56. Ornello R et al. Menstrual Headache in Women with Chronic Migraine Treated with Erenumab: An Observational Case Series. Brain Sci. 2021;11(3)

  57. Pavlovic JM et al. Efficacy and safety of erenumab in women with a history of menstrual migraine. J Headache Pain. 2020;21(1):95

  58. Adewuyi EO et al. Shared Molecular Genetic Mechanisms Underlie Endometriosis and Migraine Comorbidity. Genes (Basel). 2020;11(3)

  59. Saddik SE et al. Risk of Stroke in Migrainous Women, a Hidden Association: A Systematic Review. Cureus. 2022;14(7):e27103

  60. Siao WZ et al. Risk of peripheral artery disease and stroke in migraineurs with or without aura: a nationwide population-based cohort study. Int J Med Sci. 2022;19(7):1163-72

  61. Champaloux SW et al. Use of combined hormonal contraceptives among women with migraines and risk of ischemic stroke. Am J Obstet Gynecol. 2017;216(5):489.e1-489.e7

  62. Hormonal Contraception. Guideline of the DGGG, SGGG and OEGGG (S3-Level, AWMF Registry No. 015/015, November 2019). https://register.awmf.org/de/leitlinien/detail/015-015

  63. Diener HC et al. Therapie der Migräneattacke und Prophylaxe der Migräne, S1-Leitlinie, 2022, DGN und DMKG, in Leitlinien für Diagnostik und Therapie in der Neurologie, D.G.f.N. (Hrsg.), Editor. 2022. www.dgn.org/leitlinien.

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Die Autoren erklären, dass sie sich bei der Erstellung des Beitrages von

keinen wirtschaftlichen Interessen leiten ließen. Hartmut Göbel erklärt folgende potenzielle Interessenkonflikte: Honorare für Beratungs- oder Vortragstätigkeit von Amgen, Abbvie, Allergan, Elli Lilly, Hormosan, Lundbeck, Novartis, Organon, Teva. Sabine Segerer, Axel Heinze, Katja Heinze-Kuhn, Michael Küster, Johannes Horlemann, Michael A. Überall, Anna Cirkel, Christoph Cirkel und Carl Göbel erklären folgende potenzielle Interessenkonflikte: keine.

Der Verlag erklärt, dass die inhaltliche Qualität des Beitrags durch zwei unabhängige Gutachten bestätigt wurde. Werbung in dieser Zeitschriftenausgabe hat keinen Bezug zur CME-Fortbildung.

Der Verlag garantiert, dass die CME-Fortbildung sowie die CME-Fragen frei sind von werblichen Aussagen und keinerlei Produktempfehlungen enthalten. Dies gilt insbesondere für Präparate, die zur Therapie des dargestellten Krankheitsbildes geeignet sind.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Göbel, H., Segerer, S., Heinze, A. et al. Hormonelle Kontrazeptiva bei menstrueller Migräne. Schmerzmed. 39, 38–51 (2023). https://doi.org/10.1007/s00940-023-4123-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00940-023-4123-3

Navigation