Levels of female hormones decline sharply just before the menstrual period begins, and based on this hormonal relationship of migraine to menstruation, a study was conducted to determine the impact of oral contraceptives on the frequency and severity of migraines. Dr. Vincent de Leo and colleagues in the University of Siena’s department of obstetrics and gynecology made a randomized study of 60 women of ages from 20 to 35 years who presented with pure menstrual migraine.
Dr. Leo assigned the women to two groups with a regimen of ethinyl E2/drospirenone for three months. One group took 21 active pills followed with seven placebo pills; the other took 24 active pills and four placebos. At the beginning of the study, both groups rated their headache intensity on a scale of zero to three, with 2.7 and 2.8 ratings respectively, and both groups reported an average of three days of migraine per month.
After three months, both groups reported a decrease in severity of migraine pain, and a shorter duration. However, those who took 24 active pills reported a greater level of relief, down to one on the scale, while those who took only 21 of the active pills reported an average of 1.4 in severity. Those in the 24-active group also reported about half a day less per month in duration of their migraines.
The researchers’ conclusion was that the 24/4 regimen should be the recommended course of treatment for women suffering from pure menstrual migraine.