Combined oral contraceptives in women with menstrual migraine without aura

ObjectiveTo compare the efficacy of two regimens (21 active pills + 7 placebo pills vs. 24 active pills + 4 placebo pills) of combined oral contraception (COC), both containing 20 μg of ethinyl E2 and 3 mg of drospirenone, in improving the severity of pure menstrual migraine without aura.DesignProspective randomized study.SettingPatients attending the gynecology department of the University of Siena for consultation regarding an appropriate contraception.Patient(s)Women ages 20 to 35 years (n = 60) suffering from pure menstrual migraine without aura.Intervention(s)Three months of contraceptive use (ethinyl E2 20 μg/drospirenone 3 mg) in two different regimens: group A received 21 active + 7 placebo pills whereas group B received 24 active + 4 placebo pills.Main Outcome Measure(s)Monthly evaluation of the duration and severity of patients’ daily headache attacks.Result(s)Although both study groups demonstrated significant reduction in the intensity and duration of menstrual migraine, patients in group B (24/4 COC) reported a significant reduction in the intensity and a shorter duration of their menstrual migraine, compared with group A (21/7 COC).Conclusion(s)The 24/4 COC regimen is recommended as the preferred treatment for patients suffering from pure menstrual migraine without aura.