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Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and "add-back" therapy.

Abstract：

OBJECTIVE:To determine the efficacy of treating women with severe menstrual migraine headaches with GnRH agonist (GnRH-a) therapy, alone and combined with continuous estrogen-progestin "add-back." DESIGN:Nonrandomized, prospective treatment study. SETTING:Outpatient clinic in a university medical center. PATIENT(S):Five women who had repetitive, severe, migraine headaches limited to the perimenstrual period were selected carefully. INTERVENTION(S):After 2 months of basal evaluation, all subjects received GnRH-a (leuprolide acetate depot formulation, 3.75 mg IM, monthly) for 10 months. Beginning with the 5th month, "add-back" therapy (the addition of transdermal E2, 0.1 mg daily, and oral medroxyprogesterone acetate, 2.5 mg daily) was initiated. MAIN OUTCOME MEASURE(S):Patients rated headache severity from 0 (absent) to 3 (severe) each day; these were combined each month to obtain a cumulative score for that month. In addition, patients were asked their overall assessment of the treatments. RESULT(S):The mean headache scores for the GnRH-a treatment months (4.0 +/- 1.5, mean +/- SEM) and for the GnRH-a and "add-back" treatment months (3.1 +/- 0.7) were each significantly lower than those of the control months (15.3 +/- 2.4). The patients uniformly found both treatments to be well tolerated and near-curative for their condition. CONCLUSION(S):Gonadotropin-releasing hormone agonist administration, alone or with "add-back" therapy, is a very effective treatment for carefully selected patients with severe, perimenstrual migraine headaches.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Murray SC,Muse KN

doi

10.1016/S0015-0282(97)81928-0

subject

Has Abstract

pub_date

1997-02-01 00:00:00

pages

390-3

issue

2

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(97)81928-0

journal_volume

67

pub_type

临床试验,杂志文章

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