Migraine in the practice of an obstetrician-gynecologist

Apr 11, 2022


Migraine in the practice of an obstetrician-gynecologist

The issue of migraine and menstruation and https://pillintrip.com/ru/medicine/boxagrippal has been of interest to me for a long time, and recently I read a review of the Review of migraine incidence and management in obstetrics and gynecology / Vasilios Tanos, Elissa Abi Raad, Kelsey Elizabeth Berry and Zara Abigail Toney / European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019 -09-01
and decided to share information with you.026

Migraine is a condition characterized by recurrent episodic headache attacks, which may be preceded by a neurological symptom (aura).

Migraine is the third most common disease and the seventh most disability-related in the world. This condition can occur as a result of hormonal treatment, during menstruation, or during pregnancy. Typically, migraines are a one-sided, throbbing headache that can vary in duration and intensity, and be accompanied by nausea and vomiting. Less often, the headache proceeds with photophobia, sound phobia and paresthesias (the appearance of locally goose bumps, burning, tingling).

A migraine can start with an aura that occurs before the attack and lasts for one hour and can be expressed in various forms (for example, the sensation of some kind of smell). According to statistics, women of reproductive age are more likely to suffer from migraines. The frequency of attacks increases from the onset of menses to menopause, suggesting that sex hormones play a role in the triggering and progression of the disease.

Why should a gynecologist be familiar with this pathology and https://pillintrip.com/de/medicine/frontin and, together with a neurologist, observe and treat such patients?migren

Migraine often debuts or becomes more severe while taking combined oral contraceptives (COCs). According to studies, taking COCs on average 6 times increases the risk of developing cardiovascular complications (stroke) in women with migraine.

As stated earlier, estrogens play an important role in the development of the disease. Menstrual migraine (catamenial migraine) – associated with a drop in estrogen levels before menstruation. There are two types of catamenial migraine: the first one occurs two days before menstruation and lasts in the first 3 days of menstruation, the second type can also occur outside these periods.

In this type of migraine, COCs can prevent attacks, but taking contraceptives increases the risk of cerebrovascular thrombosis. Thus, COCs are not recommended, or rather, contraindicated for such patients, but sometimes anti-migraine drugs are used in treatment protocols and estrogens are added for several days.

Not everything is so sad! The use of pure progestin contraceptives is allowed, which sometimes helps in treatment. These drugs include Desogestrel 75 μg (two drugs with such a composition are registered in Russia – Laktinet and Charosetta).
It is very important to monitor pregnant women suffering from migraines, since such patients have a higher risk of developing hypertension during pregnancy, preeclampsia, premature placental abruption, as well as the birth of low birth weight children.

However, with breastfeeding, the migraine may subside. During pregnancy, there are no clear recommendations for treatment. Paracetamol is allowed for short-term use (cannot be used for a long time!). There is also evidence that Sumatriptan can be used in pregnant women.