Review article
https://doi.org/10.20471/may.2023.59.01.05
Specificity of Migraine Treatment in Women
Koraljka Bačić Baronica
orcid.org/0000-0003-3160-4985
; Department of Neurology, University Hospital Sveti Duh, Zagreb, Croatia; Medical School Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
Sanja Tomasović
; Department of Neurology, University Hospital Sveti Duh, Zagreb, Croatia; Medical School Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
Jelena Košćak Lukač
; Department of Neurology, University Hospital Sveti Duh, Zagreb, Croatia
Josip Sremec
; Department of Neurology, University Hospital Sveti Duh, Zagreb, Croatia
Robert Baronica
; Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
Abstract
The prevalence of migraine is higher in women than in men, with female to male ratio 3:1 in reproductive age. It is believed that sex hormones play significant role in migraine pathogenesis. Therefore, treatment of migraine in women has some specificities due to hormonal differences between sexes and due to hormonal fluctuations during menstrual cycle, pregnancy, lactation and perimenopause. Treatment of migraine during pregnancy depends on safety profile of the therapy. NSAID-s like naproxen and ibuprofen are being considered safe during the second trimester, but during the first and third trimester they may have adverse effects on pregnancy and foetus. CGRP antagonists should be avoided during pregnancy. Acetaminophen, ibuprofen, and diclofenac are considered to be safe acute therapy during breastfeeding and for preventive treatment propranolol should be used as first line therapy. Women with severe menstrual and menstrual related migraine without aura may be treated with hormonal therapy, whereas it should be avoided among patients with aura due to increased risk of stroke.
Keywords
menstruation; migraine disorders; therapeutics; pregnancy; women
Hrčak ID:
293898
URI
Publication date:
19.2.2023.
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