Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and 'add-back' therapy
| Autor: | Ken N. Muse, Shona C. Murray |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
medicine.medical_specialty medicine.drug_class Medroxyprogesterone Migraine Disorders Medroxyprogesterone Acetate Administration Cutaneous Drug Administration Schedule Gonadotropin-Releasing Hormone Leuprorelin Internal medicine Gonadotropin-releasing hormone agonist medicine Medroxyprogesterone acetate Outpatient clinic Humans Prospective Studies Prospective cohort study Menstruation Disturbances Estradiol Progesterone Congeners business.industry Obstetrics and Gynecology medicine.disease Surgery Treatment Outcome Reproductive Medicine Migraine Drug Therapy Combination Female Headaches medicine.symptom Leuprolide business medicine.drug |
| Zdroj: | Fertility and sterility. 67(2) |
| ISSN: | 0015-0282 |
| Popis: | Objective To determine the efficacy of treating women with severe menstrual migraine headaches with GnRH agonist (GnRH-a) therapy, alone and combined with continuous estrogenprogestin "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 E 2 , 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 "addback" therapy, is a very effective treatment for carefully selected patients with severe, perimenstrual migraine headaches. |
| Databáze: | OpenAIRE |
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