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Migraine Disorders: HELP
Articles by Gabriele S. Merki-Feld
Based on 7 articles published since 2008
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Between 2008 and 2019, Gabriele S. Merki-Feld wrote the following 7 articles about Migraine Disorders.
 
+ Citations + Abstracts
1 Review Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH). 2018

Sacco, Simona / Merki-Feld, Gabriele S / Ægidius, Karen Lehrmann / Bitzer, Johannes / Canonico, Marianne / Gantenbein, Andreas R / Kurth, Tobias / Lampl, Christian / Lidegaard, Øjvind / Anne MacGregor, E / MaassenVanDenBrink, Antoinette / Mitsikostas, Dimos-Dimitrios / Nappi, Rossella Elena / Ntaios, George / Paemeleire, Koen / Sandset, Per Morten / Terwindt, Gisela Marie / Vetvik, Kjersti Grøtta / Martelletti, Paolo / Anonymous32610960. ·Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it. · Clinic for Reproductive Endocrinology, Department of Gynecology, University Hospital, Zürich, Switzerland. · Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark. · Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland. · Université Paris-Saclay, University Paris-Sud, UVSQ, CESP, Inserm UMRS1018, Paris, France. · Neurology & Neurorehabilitation, RehaClinic, Bad Zurzach, University of Zurich, Zürich, Switzerland. · Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Headache Medical Center Seilerstaette Linz, Linz, Austria. · Department of Geriatric Medicine Ordensklinikum Linz, Linz, Austria. · Department of Obstetrics & Gynaecology, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. · Centre for Neuroscience & Trauma, BICMS, Barts and the London School of Medicine and Dentistry, London, UK. · Barts Health NHS Trust, London, UK. · Erasmus Medical Center Rotterdam, Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Rotterdam, The Netherlands. · Department of Neurology, University of Athens, Athens, Greece. · Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. · University Consortium for Adaptive Disorders and Head Pain (UCADH), University of Pavia, Pavia, Italy. · Department of Medicine, University of Thessaly, Larissa, Greece. · Department of Neurology, Ghent University Hospital, Ghent, Belgium. · University Hospital Rikshospitalet, University of Oslo, Oslo, Norway. · Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands. · Department of Neurology, Akershus University Hospital, Lørenskog, Norway. · Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. ·J Headache Pain · Pubmed #30171365.

ABSTRACT: We systematically reviewed data about the effect of exogenous estrogens and progestogens on the course of migraine during reproductive age. Thereafter a consensus procedure among international experts was undertaken to develop statements to support clinical decision making, in terms of possible effects on migraine course of exogenous estrogens and progestogens and on possible treatment of headache associated with the use or with the withdrawal of hormones. Overall, quality of current evidence is low. Recommendations are provided for all the compounds with available evidence including the conventional 21/7 combined hormonal contraception, the desogestrel only oral pill, combined oral contraceptives with shortened pill-free interval, combined oral contraceptives with estradiol supplementation during the pill-free interval, extended regimen of combined hormonal contraceptive with pill or patch, combined hormonal contraceptive vaginal ring, transdermal estradiol supplementation with gel, transdermal estradiol supplementation with patch, subcutaneous estrogen implant with cyclical oral progestogen. As the quality of available data is poor, further research is needed on this topic to improve the knowledge about the use of estrogens and progestogens in women with migraine. There is a need for better management of headaches related to the use of hormones or their withdrawal.

2 Review Hormonal contraception in women with migraine: is progestogen-only contraception a better choice? 2013

Nappi, Rossella E / Merki-Feld, Gabriele S / Terreno, Erica / Pellegrinelli, Alice / Viana, Michele. · ·J Headache Pain · Pubmed #24456509.

ABSTRACT: A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75μg has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies.

3 Article Hormonal contraceptives and risk of ischemic stroke in women with migraine: a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC). 2017

Sacco, Simona / Merki-Feld, Gabriele S / Ægidius, Karen Lehrmann / Bitzer, Johannes / Canonico, Marianne / Kurth, Tobias / Lampl, Christian / Lidegaard, Øjvind / Anne MacGregor, E / MaassenVanDenBrink, Antoinette / Mitsikostas, Dimos-Dimitrios / Nappi, Rossella Elena / Ntaios, George / Sandset, Per Morten / Martelletti, Paolo / Anonymous2680925. ·Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it. · Department of Gynecology, Clinic for Reproductive Endocrinology, University Hospital, Zürich, Switzerland. · Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark. · Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland. · Université Paris-Saclay, University Paris-Sud, UVSQ, CESP, Inserm UMRS1018, Orsay, France. · Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Headache Medical Center Seilerstaette Linz, Linz, Austria. · Department of Geriatric Medicine Ordensklinikum Linz, Linz, Austria. · Department of Obstetrics & Gynaecology, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. · Centre for Neuroscience & Trauma, BICMS, Barts and the London School of Medicine and Dentistry, London, UK. · Barts Sexual Health Centre, St Bartholomew's Hospital, London, UK. · Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands. · Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece. · Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. · University Consortium for Adaptive Disorders and Head Pain (UCADH), University of Pavia, Pavia, Italy. · Department of Medicine, University of Thessaly, Larissa, Greece. · Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway. · Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. · Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy. ·J Headache Pain · Pubmed #29086160.

ABSTRACT: Several data indicate that migraine, especially migraine with aura, is associated with an increased risk of ischemic stroke and other vascular events. Of concern is whether the risk of ischemic stroke in migraineurs is magnified by the use of hormonal contraceptives. As migraine prevalence is high in women of reproductive age, it is common to face the issue of migraine and hormonal contraceptive use in clinical practice. In this document, we systematically reviewed data about the association between migraine, ischemic stroke and hormonal contraceptive use. Thereafter a consensus procedure among international experts was done to develop statements to support clinical decision making, in terms of cardiovascular safety, for prescription of hormonal contraceptives to women with migraine. Overall, quality of current evidence regarding the risk of ischemic stroke in migraineurs associated with the use of hormonal contraceptives is low. Available data suggest that combined hormonal contraceptive may further increase the risk of ischemic stroke in those who have migraine, specifically migraine with aura. Thus, our current statements privilege safety and provide several suggestions to try to avoid possible risks. As the quality of available data is poor further research is needed on this topic to increase safe use of hormonal contraceptives in women with migraine.

4 Article Temporal relations in hormone-withdrawal migraines and impact on prevention- a diary-based pilot study in combined hormonal contraceptive users. 2017

Merki-Feld, Gabriele S / Epple, Gina / Caveng, Nina / Imthurn, Bruno / Seifert, Burkhardt / Sandor, Peter / Gantenbein, Andreas R. ·Department of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstrasse 10, CH - 8091, Zürich, Switzerland. gabriele.merki@usz.ch. · Department of Reproductive Endocrinology, University Hospital Zürich, Frauenklinikstrasse 10, CH - 8091, Zürich, Switzerland. · Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zürich, Zürich, Switzerland. · Neurorehabilitation Rehaclinic Bad Zurzach, Zürich, Switzerland. ·J Headache Pain · Pubmed #28842849.

ABSTRACT: BACKGROUND: Menstrually related migraine (MRM) in the hormone-free interval (HFI) of combined hormonal contraceptives (CHC) are according to the ICHD definition also estrogen withdrawal migraines (EWH). MRMs are less responsive to acute medication. Therefore short-term prevention, initiated 1-2 days before onset of the anticipated bleeding and continued for 6 days, is recommended. Such a long prophylactic triptan use might increase the risk for medication overuse headache in women suffering in addition from non-menstrual migraines. In CHC users onset of hormone decline is predictable. It is however unknown, whether the EWHs are rather associated with onset of hormone withdrawal or onset of bleeding. Improved understanding of this relation might contribute to better define and shorten the time interval for prevention. METHODS: For this observational diary-based pilot study we collected data from daily conducted headache diaries of CHC users with MRM in at least two of three cycles, visiting our clinic from 2009 to 2015. We analyzed frequency of migraines for each hormone free day, onset of migraine, onset of bleeding and the relation of migraine to onset of bleeding in the 7-day period following estrogen withdrawal. We identified in addition the onset of migraine attacks lasting more than 1 day (episodes). RESULTS: Forty patient charts met the inclusion criteria, what allowed us to analyze 103 cycles. The mean number of migraine days in the HFI was 2.2 ± 1.6. Migraine started typically on days 1-5 and bleeding on days 3-5. In relation to first day of bleeding, migraines started on days -1 to 4. Almost half of the migraine attacks lasted longer than 24 h, despite the use of rescue medication. CONCLUSION: MRM in CHC users starts on bleeding days -1 to 4, what differs from findings in the natural cycle. Referring to the HFI interval migraine started mostly on days 1-5. According to these data, it seems to be reasonable to initiate short-term prevention at the last day of pill use or the first day of the HFI and continue for 5 days.

5 Article Improvement of migraine with change from combined hormonal contraceptives to progestin-only contraception with desogestrel: How strong is the effect of taking women off combined contraceptives? 2017

Merki-Feld, Gabriele S / Imthurn, Bruno / Dubey, Raghvendran / Sándor, Peter S / Gantenbein, Andreas R. ·a Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , University Hospital Zürich , Zurich , Switzerland. · b Headache outpatient Clinic, Department of Neurorehabilitation , Reha Clinic Bad Zurzach & Baden , Bad Zurzach , Switzerland. · c Headache and Pain Unit, Department for Neurology , University Hospital Zürich , Zurich , Switzerland. ·J Obstet Gynaecol · Pubmed #28129717.

ABSTRACT: Migraine is a disabling headache disorder, which affects up to 17% of the female population. Oestrogen withdrawal during the menstrual cycle or the hormone-free interval in users of combined hormonal contraceptives (CHC) plays a pivotal role. Two diary-based studies demonstrated a positive impact of the progestin-only pill (POP) desogestrel 75 μg on the frequency of the migraine attacks and pain intensity. In both studies, CHC users as well as nonusers were included, which makes it difficult to distinguish between the effect of taking women off the CHC and the benefit of the POP itself. With the present study, we compared the therapeutic effect of the POP desogestrel 75 μg on migraine in current CHC users and nonusers. We found a positive influence of desogestrel on migraine not only in women who switched from CHCs to desogestrel, but also in those who had not used hormones over 6 months before starting it. Our findings need to be confirmed in prospectively conducted studies with larger sample size.

6 Article Positive effects of the progestin desogestrel 75 μg on migraine frequency and use of acute medication are sustained over a treatment period of 180 days. 2015

Merki-Feld, Gabriele S / Imthurn, Bruno / Langner, Ronald / Seifert, Burkhardt / Gantenbein, Andreas R. ·Department of Reproductive Endocrinology, University Hospital Zürich, Rämistrasse 100, CH - 8091, Zürich, Switzerland, gabriele.merki@usz.ch. ·J Headache Pain · Pubmed #25933634.

ABSTRACT: BACKGROUND: Premenopausal migraines frequently are associated with fluctuations of estrogen levels. Both, migraine and combined hormonal contraceptives (CHC) increase the risk of vascular events. Therefore progestagen-only contraceptives (POC) are a safer alternative. A previous short-term study demonstrated a positive impact of the oral POC desogestrel on migraine frequency. To study the effect of the POC desogestrel 75 μg on migraine frequency, intensity, use of acute medication and quality of life in a clinical setting over the period of 180 days. METHODS: Patients' charts were screened for women with migraine, who had decided to use desogestrel for contraception. Charts were included, if routinely conducted headache diaries were complete for 90 days before treatment (baseline) and over a treatment period of 180 days. We also report about starters who stopped treatment early, because of adverse events. Baseline data (day 1-90 before treatment) were compared with first and second treatment period (treatment days 1-90 and days 91-180). Quality of life was evaluated using MIDAS questionnaires. RESULTS: Days with migraine (5.8 vs 3.6), with any kind of headache (9.4 vs 6.6), headache intensity (15.7 vs 10.7), days with severe headache (5.4 vs 2.4) and use of triptans (12.3 vs7.8) were significantly reduced after 180 days. MIDAS score and grade improved significantly. CONCLUSION: Contraception with desogestrel 75 μg resulted in a significantly improved quality of life and a reduction of migraine days over the observation period of 180 days. A clinically meaningful 30% reduction in pain was observed in 25/42 (60%) participants. For counselling reasons it is of importance, that the major reduction in migraine frequency occured during the initial 90 days, however further improvement occurs with longer duration of use. Prospective studies are needed to confirm these results.

7 Article Desogestrel-only contraception may reduce headache frequency and improve quality of life in women suffering from migraine. 2013

Merki-Feld, Gabriele S / Imthurn, Bruno / Seifert, Burkhardt / Merki, Laura L / Agosti, Reto / Gantenbein, Andreas R. ·* Clinic for Reproductive Endocrinology, Department of Gynaecology and Obstetrics, University Hospital Zürich , Switzerland. ·Eur J Contracept Reprod Health Care · Pubmed #23927694.

ABSTRACT: OBJECTIVE: To analyse the effects of a three-month course of progestogen-only contraception with desogestrel 75 μg on disability, headache frequency and headache intensity in migraineurs. MATERIALS AND METHODS: Migraine disability headache questionnaires (MIDAS) were collected from 37 migraineurs during counselling, and at the end of three months treatment with desogestrel. Another ten women initiated but did not complete treatment. They are included in the overall evaluations of the effect of the regimen on migraine status. RESULTS: Desogestrel was associated with significant reductions in headache days and intensity (p < 0.001; p < 0.006), and a significant improvement in quality of life. Days missed at work and days missing leisure activities diminished (p < 0.001; p < 0.001). The MIDAS migraine disability score improved significantly (from 27.4 to 11.1 points) (p < 0.001). While 25 of the 37 women (68%) experienced a decrease of at least one grade, this level of benefit cannot be extrapolated to all initiators. When dropouts are considered, MIDAS grades decrease in 53% (25/47) of the cases. CONCLUSION: The majority of migraineurs experienced a clinically significant reduction in headache frequency and improvement of quality of life with use of desogestrel. Prospective randomised controlled trials are needed to substantiate our results.