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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recently there have been reports that long-term use of estrogen- containing oral contraceptives (OCs) can induce folic acid and vitamin B deficiency which can lead to hematopoiesis. The symptoms are paleness, forgetfulness, sleeplessness, and euphoric and depressive states. This deficiency occurs when serum folic content falls below 8 nmol/1 or 3 ng/ml. According to a nutrition group blood folic acid level declined up to 40% in patients taking OCs. In a Sri Lanka study of healthy women aged 20-45 taking Ovulen 50 (.05 mg of ethinyl estradiol and 1 mg of ethynodiol diacetate) folic acid level dropped in the 1st 6 months stabilizing at 2.2 ng/ml in those from the lowest social classes and at 2.9 ng/ml in those from privileged classes. Prophylactic substitution of folic acid in the diet was recommended by WHO, but it is less effective since it appears in the diet as polyglutamate that has to be broken down to absorbable monoglutamate. A US study found that taking OCs for 60 months resulted in a 40% reduction of the vitamin B12 serum level, while vitamin B12 concentrations in erythrocytes and peripheral blood stayed normal. Vitamin B12 helps recover tetrahydrofolic acid from N-methyltetrahydrofolic acid. Possibly this is another manifestation of OC-induced folic acid hypovitaminosis. OCs can also influence tryptophan metabolism reducing its blood concentration whereby less 5-hydroxytryptamine (serotonin) is produced. This results in headache, concentration decreases irritability, and sleep disturbances. In addition, lower riboflavin (vitamin B2) and thiamin concentration in erythrocytes was reported after using OCs. Counseling on the possible effect on vitamin stores and on proper nutrition including folic acid as monoglutamate is necessary for women who use OCs or estrogen substitution therapy for postmenopause or for osteoporosis prophylaxis.
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PMID:[Folic acid and vitamin deficiency caused by oral contraceptives]. 192 42

From August 1988-June 1989, 983 physicians participated in a phase IV trial by following 7759 women using the monophasic oral contraceptive (OC), Demulen 1/35 (1 mg ethynodiol diacetate and 35 ug ethinyl estradiol) to evaluate its efficacy and safety. The total number of cycles for the study stood at 21,440. In addition, the total woman-years stood at 1787. Only 6382 patients could be evaluated for safety. 4.4% of the patients had adverse reactions to the OC, but only 1.7% of all patients stopped taking it. The leading side effects included nausea (67 cases), headache (45), amenorrhea (42), emotional changes (30), breast pain (19), dysmenorrhea (12), and 11 cases of weight gain, abdominal/pelvic pain, and bloating. Of the 280 reported adverse reactions, only 87 (31%) were considered severe. The leading serious adverse reactions were depression (10) and hypertension (6). Only 5412 patients could be used to determine efficacy. The physicians initially reported 121 (2.2%) pregnancies during the study. The researchers learned that 33 of the 84 returned 2nd questionnaires (response rate, 70%) reported that the women conceived after enrollment but before taking the OC. 36 conceived while taking it, but 8 did not take it daily. Noncompliance may have contributed to pregnancy for the remaining 28 cases. Therefore the 36 confirmed pregnancies made for a failure rate of .7%. 85.7% of the pregnancies happened in the 1st 3 months of taking the OC. Either patient noncompliance or true medication failure accounted for treatment failure. Therefore it is important for physicians to instruct patients on how to take OCs correctly.
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PMID:Efficacy and safety of ethynodiol diacetate, 1 mg, with ethinyl estradiol, 35 micrograms, with an emphasis on contraceptive efficacy. A phase IV trial. 204 81

This article reports on a study concerning the relationship between migraine headaches and the use of the low-dose oral contraceptives Rigevidon and Anteovin. The objective was to examine how hormonal contraception influences vascular headaches and to what extent does it provoke such complaints. The study involved 138 and 441 women taking Rigevidon and Anteovin, respectively, 7.9-10.1% of whom already suffered from migraine headaches before taking the pill. Researchers observed the time of the development of the migrainous attack, its duration and intensity, and its course during each cycle. In the event of very intense headaches, the researchers changed the oral contraceptive to Ovidon or Continuin, or discontinued treatment (treatment was also discontinued in cases of increases in blood pressure). Of the women already suffering from headaches prior to taking the oral contraceptives, most of them suffered from a typical menstrual migraines caused by premenstrual syndrome which lasted for 2-4 days. The study found that the women on Rigevidon were less likely to suffer from vascular headaches than the women on Anteovin. While Anteovin caused classic migraine headaches on 0.98% of the women and atypical migraine headaches on 2.3% for the women, the figures were only 0.7% and 1.4% for women on Rigevidon. Researchers attribute these differences to the fact that Anteovin has a higher oestrogen content than Rigevidon. While the study does not explain the correlation between low-dose oral contraceptives and vascular headaches, it does point out the risk associated with oestrogen.
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PMID:The relationship between vascular headaches and low-dose oral contraceptives. 209 59

Medical histories of 436 patients treated with Ovulen after childbirth or an abortion were examined in order to collect a sample of women who had taken the orals for 6-12 cycles. A group of 70 patients was thus formed. The following parameters were investigated: weight variation; blood pressure; nausea and vomiting; varicosities; variation in menstrual flow and length of period; breast-related side effects; jaundice; psychic alteration, i.e., nervousness, anxiety, or depression; changes in libido; headaches; skin changes; and pregnancy. Results are presented both in graph and table form. Weight change was found to tend more to loss than to gain. No statistically significant changes in blood pressure were observed. Nausea and associated symptoms tended to disappear after the 9th cycle. Edema was present in only 6% of all cycles. The most common side effect was varicosities, present in 25% of the sample, but in no instance did thrombosis occur nor was varicosity a cause for discontinuation in any case. Breast-related side effects were more common at the outset. No jaundice was observed. Psychic alterations were not common and were mostly insignificant and tended to occur more frequently at the outset. 12% of the sample had headaches from the beginning of treatment up until the 8th month, after which they began to disappear. Only 1 patient had chloasma and then only during the 1st 2 cycles. There was a marked tendency toward menorrhagia which was thought to be beneficial due to the prevalence of anemia in the group. Changes in libido were minimal and tended to disappear after the 8th cycle. None of the patients became pregnant.
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PMID:[Secondary effects of ethynodiol diacetate plus mestranol]. 535 18

203 women 19-40 years of age were administered the gestagen preparations Volidan, Cyclofarlutal, Ovulen, Ciba AC-101, and Stediril as a contraceptive. 49 other women were administered these preparations as therapeutic and/or diagnostic measures in different gynecological complications. Side effects such as spotting, acylic bleeding, nausea, headaches and breast swelling were more frequent with the high-dose preparations such as Volidan and Cyclofarlutal. Intolerance to the preparation and subsequent discontinuation occurred only in a small percentage of the users. All of the preparations achieved 100% effectiveness as contraceptives. It is noted that these preparations were used with some success in treating dysmenorrhea, menometrorrhagia because of hyperplasia of the endometrium, and in severe climacteric syndromes. It has also been used as a pregnancy test. Constant medical control of the administration of these preparations is necessary both when they are used as contraceptives and as therapeutic measures, particularly in the case of young women.
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PMID:[Clinical aspects of the administration of gestagen preparations (Volidan, Cyclofarlutal, Ovulen, Ciba AC-101 and Steridil)]. 545 44

75 patients with cluster headache (63 men and 12 women) and 939 with migraine headache were seen among 1260 new patients at the Princess Margaret Migraine Clinic of Charing Cross Hospital (London, England) over a 16-month period. 3 points of interest emerged from this analysis. The age of onset in women, unlike the men, appeared to be bimodal. Approximately half of the women developed the condition in early adult life, and the remainder at about the time of the menopause. These distributions were significantly different. This was not noted in Ekbom's earlier series nor in that of Pearce, although Ekbom did record a disproportionate number of old women at presentation. Atypical cases seemed more common among women and especially among those women who developed headaches later in life. There were no satisfactory criteria for the classification of less typical cases, e.g., patients with single weekly attacks typical in site and duration, or patients with bout up to 12 attacks daily but with long headache free intervals that would appear to exclude the diagnosis of chronic paroxysmal hemicrania. 6 of the 7 typical premenstrual cases had been on oral contraceptives (OCs), and 4 of these associated breaks from contraception with the start of clusters. They could not abort a cluster by immediately restarting OC. In 1 case there was a temporal association with a change from Ovulen 50 to Ovranette, and the headaches settled when she was changed back to Ovulen 50 3 months later. They recurred when she stopped the Ovulen 50 again after 4 months, and she conceived during the cluster, which ceased in the 4th week of pregnancy. She had another cluster, lasting 6 weeks, which started when she was 11 weeks pregnant but none later in the pregnancy. She had a further cluster 7 months postpartum, and hormonal treatment has been contraindicated by a postpartum thrombosis. The anecdotal nature of this observation cannot be denied, but a large scale trial is not feasible. Longterm OC use, possibly with a 50 mcg estrogen preparation, might be helpful in occasional patients. This phenomenon is the opposite of that found in migraine, emphasizing the distinction between the 2 conditions.
Cephalalgia 1982 Sep
PMID:Cluster headache in women. 715 Nov 51