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ALL / Neurology
Migraine: pregnancy, contraception and other hormonal factors
Migraine: pregnancy, contraception and other hormonal factors
SIGN produced guidelines in 2008 on the management of migraine, the following is selected highlights:Migraine during pregnancy
- paracetamol 1g is first-line
- NSAIDs can be used second-line in the first and second trimester
- avoid aspirin and opioids such as codeine during pregnancy
Migraine and the combined oral contraceptive (COC) pill
- if patients have migraine with aura then the COC is absolutely contraindicated due to an increased risk of stroke (relative risk 8.72)
Migraine and menstruation
- many women find that the frequency and severity of migraines increase around the time of menstruation
- SIGN recommends that women are treated with mefanamic acid or a combination of aspirin, paracetamol and caffeine. Triptans are also recommended in the acute situation
Migraine and hormone replacement therapy (HRT)
- safe to prescribe HRT for patients with a history of migraine but it may make migraines worse
+PassMedicine Notes
SIGN produced guidelines in 2008 on the management of migraine, the following is selected highlights:
Migraine during pregnancy- paracetamol 1g is first-line
- NSAIDs can be used second-line in the first and second trimester
- avoid aspirin and opioids such as codeine during pregnancy
- if patients have migraine with aura then the COC is absolutely contraindicated due to an increased risk of stroke (relative risk 8.72)
- many women find that the frequency and severity of migraines increase around the time of menstruation
- SIGN recommends that women are treated with mefanamic acid or a combination of aspirin, paracetamol and caffeine. Triptans are also recommended in the acute situation
- safe to prescribe HRT for patients with a history of migraine but it may make migraines worse