EHMTI-0188. Contraceptive-induced amenorrhoea leads to reduced migraine frequency in women with menstrual migraine

Introduction

Menstrual migraine without aura (MM) is defined as attacks of migraine without aura (MO) occurring on day 1±2 of the menstrual cycle in at least 2/3 menstruations. Population-based studies shows that MM affects approximately 20% of female migraineurs in their 30s. Many women in this age group need contraception.

Aim

The aim of the present study was to investigate the influence of hormonal contraception on attacks of migraine without aura (MO) in women with a history of MM.

Methods

A total of 237 women from the general population with self-reported migraine in at least half of their menstruations were interviewed about headache and course of headache during use of hormonal contraception by a neurologist. Among these, 141 women had a history of MM according to the International Classification of Headache Disorders II.

Results

Among 141 women with a history of MM, 49 women were currently using hormonal contraception. Of these, 23 reported amenorrhoea and the remaining reported withdrawal bleeds/menstruation. Significantly more women with amenorrhoea reported no MO-attacks during the preceding month compared to women without amenorrhoea (OR 16.1; 95% confidence interval (CI) 1.8-140.4; P = 0.003). A reduction of MO-frequency was more often reported in women with than without amenorrhoea (OR 3.5; 95% CI 1.1-11.4; P = 0.04). Pain intensity and attack duration did not differ between the groups.

Conclusion

Amenorrhoea leads to a reduction of MO-frequency in women with MM using hormonal contraceptives. Future prospective studies on MM should focus on contraceptive methods that achieve amenorrhoea.

No conflict of interest.