Progestin-only contraception compared with extended combined oral contraceptive in women with migraine without aura: A retrospective pilot study

Objective To evaluate the effect of a desogestrel progestogen-only pill (POP) compared to continuous combined oral contraception (COC) on migraine patterns in women with migraine without aura. Study design A retrospective analysis of prospective headache charts from migrainous women who used the POP or COC in our clinic between July 2009 and July 2013. The quality and quantity of migraine attacks and use of medications were evaluated at three and six months. Health related quality of life was evaluated after 6 months' treatment. Results Fifty-three patients were evaluable for the analysis (22 in the COC group and 31 in the POP group). Six months' POP treatment led to a statistical reduction in migraine days; headache days; pain intensity; number of days with severe pain and days with pain medication. The only statistical difference between the two groups was a reduction in the number of days with pain medication in the POP group compared to the COC group (p = 0.044). After 6 months' treatment a quality of life improvement was seen only in the POP group, but no statistical differences were found when comparing the two groups. Conclusions Our preliminary data confirm that POP therapy improves migraine patterns and quality of life after 6 months' treatment in women with migraine without aura and it decreases the analgesic consumption with respect to an extended COC therapy. As POP represents a healthier opportunity, in terms of vascular risk, than combined contraception, its role in migrainous women deserves to be further investigated.