Medical oophorectomy with and without estrogen add-back therapy in the prevention of migraine headache.

摘要: Objectives.—To determine the preventive benefit of “medical oophorectomy” and transdermal estradiol in women with migraine. Background.—Epidemiological studies have demonstrated that declines serum estrogen levels occurring during normal menstrual cycles can trigger headache migraine. Prior to this study, no randomized controlled trials evaluated whether minimizing these hormonal changes pharmacologically prevent headache. Methods.—Twenty-one regular a diagnosis migraine were enrolled. After 2.5-month placebo run-in phase, all patients received subcutaneous goserelin implant (a gonadotropin-releasing hormone agonist) induce medical oophorectomy. One month later, while continuing goserelin, participants receive patch containing 100 μg estradiol-17β (gonadotropin-releasing agonist/estradiol group, n  =  9) or agonist/placebo n  =  12) 2-month treatment phase. The primary outcome measure was index, which defined as mean pain severity ratings (0 10 scale) recorded three times per day by daily diary. Secondary measures included disability, severity, frequency, percentage headaches rating 7 greater. Results.—The index significantly lower period group than (P  =  .025). Similar improvements observed for secondary exception unchanged between groups. Within there 33.7% reduction (95% confidence interval, −64.4 −3.0) phase when compared phase; difference seen those phases within group. Conclusions.—Minimization fluctuations agonist therapy alone is inadequate who are premenopausal addition existing provides modest benefit.