nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2019-3-11-15nnp-1167Research ArticleCLINICAL GUIDELINESКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИHormonal contraceptives and the risk of ischemic stroke in women with migraine: a new international consensusГормональные контрацептивы и риск ишемического инсульта у женщин с мигренью: новый международный консенсусЕкушеваЕ. В.EkushevaE. V.

125371, Москва, Волоколамское шоссе, 91

91, Volokolamskoe Shosse, Moscow 125371

ekushevaev@mail.ruКарповаМ. И.KarpovaM. I.

454092, Челябинск, ул. Воровского, 64

64, Vorovsky St., Chelyabinsk 454092

ОсиповаВ. В.OsipovaV. V.

119991, Москва, ул. Трубецкая, 8, стр. 2;

115419, Москва, ул. Донская, 43;

121467, Москва, ул. Молодогвардейская, 2, корп. 1

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43, Donskaya St., Moscow 115419;

2, Molodogvardeiskaya St., Build. 1, Moscow 121467

Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»РоссияAcademy of Postgraduate Education «Federal Research and Clinical Center for Specialized Medical Care Types and Medical Technologies, Federal Biomedical Agency of Russia»Russian FederationФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth Ural State Medical University, Ministry of Health of RussiaRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава России; ГБУЗ «Научно-практический психоневрологический центр им. З.П. Соловьева Департамента здравоохранения города Москвы»; ООО «Университетская клиника головной боли»РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Z.P. Solovyev Research and Practical Center of Psychoneurology, Moscow Healthcare Department; OOO «University Clinic of Headache»Russian Federation2019291020191131115Copyright © Ekusheva E.V., Karpova M.I., Osipova V.V., 20192019Екушева Е.В., Карпова М.И., Осипова В.В.Ekusheva E.V., Karpova M.I., Osipova V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1167

The paper is devoted to the safe use of hormonal contraception in women with migraine, an urgent interdisciplinary problem daily faced by gynecologists, neurologists, and specialists in headache diagnosis and treatment. It gives information on the prevalence of migraine, the risk of ischemic stroke and other cardiovascular disorders in women with different types of migraine, including those receiving contraception and hormone replacement therapy. The paper presents the main provisions of the new interdisciplinary consensus «Hormonal contraceptives and the risk of ischemic stroke in women who have migraine», which are recommended to be taken into account by specialists of any profile when prescribing hormonal therapy to women with migraine in order to avoid cardiovascular events.

Статья посвящена безопасному применению гормональной контрацепции у женщин с мигренью – актуальной междисциплинарной проблеме, с которой ежедневно сталкиваются гинекологи, неврологи и специалисты в области диагностики и лечения головной боли. Приведены сведения о распространенности мигрени, риске ишемического инсульта и других сердечно-сосудистых нарушений у женщин с различными формами мигрени, в том числе у получающих противозачаточную и заместительную гормональную терапию. В статье приведены основные положения нового междисциплинарного консенсуса «Гормональные контрацептивы и риск ишемического инсульта у женщин с мигренью», которые рекомендуется учитывать специалистам любого профиля при назначении гормональной терапии женщинам с мигренью во избежание развития сердечно-сосудистых осложнений.

мигрень у женщинмигрень с ауройгормональная контрацепциясердечно-сосудистые событияриск ишемического инсультаmigraine in womenmigraine with aurahormonal contraceptioncardiovascular eventsrisk of ischemic strokeReferencesGlobal, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2017;390:1211-1859. doi:10.1016/S0140-6736 (17)32154-2Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2017;390:1211-1859. doi:10.1016/S0140-6736 (17)32154-2Tietjen GE, Collins SA. Hypercoagulability and migraine. Headache. 2018;58(1):173-183. http://dx.doi.org/10.1111/head.13044Tietjen GE, Collins SA. Hypercoagulability and migraine. Headache. 2018;58(1):173-183. http://dx.doi.org/10.1111/head.13044Ayzenberg I, Katsarava Z, Sborowski A, et al. The prevalence of primary headache disorders in Russia: A countrywide survey. Cephalalgia. 2012 Apr;32(5):373-81. doi: 10.1177/0333102412438977. Epub 2012 Mar 6.Ayzenberg I, Katsarava Z, Sborowski A, et al. The prevalence of primary headache disorders in Russia: A countrywide survey. Cephalalgia. 2012 Apr;32(5):373-81. doi: 10.1177/0333102412438977. Epub 2012 Mar 6.Осипова ВВ, Табеева ГР. Первичные головные боли: диагностика, клиника, терапия: практическое руководство. Москва: МИА; 2014. 336 с.Osipova VV, Tabeeva GR. Pervichnye golovnye boli: diagnostika, klinika, terapiya: Prakticheskoe rukovodstvo [Primary headaches: diagnosis, clinic, therapy: a practical guide]. Moscow: MIA; 2014. 336 p.Екушева ЕВ. Оптимальные подходы к купированию приступа мигрени: прошлое, настоящее и будущее. Русский медицинский журнал. 2012;(10):522-8.Ekusheva EV. Optimal approaches to arresting a migraine attack: past, present and future. Russkii meditsinskii zhurnal. 2012;(10):522-8 (In Russ.).Finocchi C, Strada L. Sex-related differences in migraine. Neurol Sci. 2014 May;35 Suppl 1:207-13. doi: 10.1007/s10072-014-1772-y.Finocchi C, Strada L. Sex-related differences in migraine. Neurol Sci. 2014 May;35 Suppl 1:207-13. doi: 10.1007/s10072-014-1772-y.Buse DC, Reed ML, Fanning KM, et al. Cardiovascular events, conditions, and procedures among people with episodic migraine in the US population: results from the American Migraine Prevalence and Prevention (AMPP) study. Headache. 2017 Jan;57(1):31-44. doi: 10.1111/head.12962. Epub 2016 Nov 12.Buse DC, Reed ML, Fanning KM, et al. Cardiovascular events, conditions, and procedures among people with episodic migraine in the US population: results from the American Migraine Prevalence and Prevention (AMPP) study. Headache. 2017 Jan;57(1):31-44. doi: 10.1111/head.12962. Epub 2016 Nov 12.Peng KP, Chen YT, Fuh JL, et al. Migraine and incidence of ischemic stroke: A nationwide population-based study. Cephalalgia. 2017 Apr; 37(4):327-335. doi: 10.1177/0333102416642602. Epub 2016 Apr 26.Peng KP, Chen YT, Fuh JL, et al. Migraine and incidence of ischemic stroke: A nationwide population-based study. Cephalalgia. 2017 Apr; 37(4):327-335. doi: 10.1177/0333102416642602. Epub 2016 Apr 26.Sacco S, Ricci S, Carolei A. Migraine and vascular diseases: a review of the evidence and potential implications for management. Cephalalgia. 2012 Jul;32(10):785-95. doi: 10.1177/0333102412451361. Epub 2012 Jun 18.Sacco S, Ricci S, Carolei A. Migraine and vascular diseases: a review of the evidence and potential implications for management. Cephalalgia. 2012 Jul;32(10):785-95. doi: 10.1177/0333102412451361. Epub 2012 Jun 18.Carolei A, Marini C, De Matteis G. History of migraine and risk of cerebral ischaemia in young adults. The Italian national research council study group on stroke in the young. Lancet. 1996 Jun 1;347(9014):1503-6.Carolei A, Marini C, De Matteis G. History of migraine and risk of cerebral ischaemia in young adults. The Italian national research council study group on stroke in the young. Lancet. 1996 Jun 1;347(9014):1503-6.Nicodemo M, Cevoli S, Giannini G, Cortelli P. Comorbidity in perimenstrual migraine. Curr Pain Headache Rep. 2012 Oct;16(5):477-83. doi: 10.1007/s11916-012-0281-z.Nicodemo M, Cevoli S, Giannini G, Cortelli P. Comorbidity in perimenstrual migraine. Curr Pain Headache Rep. 2012 Oct;16(5):477-83. doi: 10.1007/s11916-012-0281-z.Todd C, Lagman-Bartolome AM, Lay C. Women and migraine: the role of hormones. Curr Neurol Neurosci Rep. 2018 May 31;18(7): 42. doi: 10.1007/s11910-018-0845-3.Todd C, Lagman-Bartolome AM, Lay C. Women and migraine: the role of hormones. Curr Neurol Neurosci Rep. 2018 May 31;18(7): 42. doi: 10.1007/s11910-018-0845-3.Sheikh HU, Pavlovic J, Loder E, Burch R. Risk of stroke associated with use of estrogen containing contraceptives in women with migraine: a systematic review. Headache. 2018 Jan;58(1):5-21. doi: 10.1111/head.13229. Epub 2017 Nov 15.Sheikh HU, Pavlovic J, Loder E, Burch R. Risk of stroke associated with use of estrogen containing contraceptives in women with migraine: a systematic review. Headache. 2018 Jan;58(1):5-21. doi: 10.1111/head.13229. Epub 2017 Nov 15.Vetvik KG, Benth JS, MacGregor EA, et al. Menstrual versus non-menstrual attacks of migraine without aura in women with and without menstrual migraine. Cephalalgia. 2015 Dec; 35(14):1261-8. doi: 10.1177/0333102415575723. Epub 2015 Mar 9.Vetvik KG, Benth JS, MacGregor EA, et al. Menstrual versus non-menstrual attacks of migraine without aura in women with and without menstrual migraine. Cephalalgia. 2015 Dec; 35(14):1261-8. doi: 10.1177/0333102415575723. Epub 2015 Mar 9.Elliott D, Li X, Zhu P, Gaitour E. Headache in pregnancy. In: Minagar A, editor. Neurological Disorders and Pregnancy. London: Elsevier; 2011. P. 19-37.Elliott D, Li X, Zhu P, Gaitour E. Headache in pregnancy. In: Minagar A, editor. Neurological Disorders and Pregnancy. London: Elsevier; 2011. P. 19-37.Medical eligibility criteria for contraceptive use, 5th ed. Geneva: WHO; 2015. 276 p.Medical eligibility criteria for contraceptive use, 5th ed. Geneva: WHO; 2015. 276 p.Sacco S, Merki-Feld GS, AEgidius KL, et al. 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). J Headache Pain. 2017 Oct 30;18(1):108. doi: 10.1186/s10194-017-0815-1.Sacco S, Merki-Feld GS, AEgidius KL, et al. 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). J Headache Pain. 2017 Oct 30;18(1):108. doi: 10.1186/s10194-017-0815-1.Abanoz Y, Abanoz YG, Gü ndü z A, et al. Migraine as a risk factor for young patients with ischemic stroke: a case-control study. NNeurol Sci. 2017 Apr;38(4):611-617. doi: 10.1007/s10072-017-2810-3. Epub 2017 Jan 12.Abanoz Y, Abanoz YG, Gü ndü z A, et al. Migraine as a risk factor for young patients with ischemic stroke: a case-control study. NNeurol Sci. 2017 Apr;38(4):611-617. doi: 10.1007/s10072-017-2810-3. Epub 2017 Jan 12.The Oral Contraceptive and Hemostasis Study Group. The effects of seven monophasic oral contraceptive regimens on hemostatic variables: conclusions from a large randomized multicenter study. Contraception. 2003 Mar; 67(3):173-85.The Oral Contraceptive and Hemostasis Study Group. The effects of seven monophasic oral contraceptive regimens on hemostatic variables: conclusions from a large randomized multicenter study. Contraception. 2003 Mar; 67(3):173-85.Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA. 2000 Jul 5;284(1):72-8.Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA. 2000 Jul 5;284(1):72-8.Calhoun A, Ford S, Pruitt A. The impact of the extended-cycle vaginal ring contraception on migraine aura: a retrospective case series. Headache. 2012 Sep;52(8):1246-53. doi: 10.1111/j.1526-4610.2012.02211.x. Epub 2012 Jul 12.Calhoun A, Ford S, Pruitt A. The impact of the extended-cycle vaginal ring contraception on migraine aura: a retrospective case series. Headache. 2012 Sep;52(8):1246-53. doi: 10.1111/j.1526-4610.2012.02211.x. Epub 2012 Jul 12.Sulak P, Willis S, Kuehl T, et al. Headaches and oral contraceptives: impact of eliminating the standard 7-day placebo interval. Headache. 2007 Jan;47(1):27-37. doi: 10.1111/j.1526-4610.2007.00650.xSulak P, Willis S, Kuehl T, et al. Headaches and oral contraceptives: impact of eliminating the standard 7-day placebo interval. Headache. 2007 Jan;47(1):27-37. doi: 10.1111/j.1526-4610.2007.00650.xNappi RE, Kaunitz AM, Britzer J. Extended regimen combined oral contraception: a review of evolving concepts and acceptance by woman and clinicians. Eur J Contracept Reprod Health Care. 2016;21(2):106-15. doi: 10.3109/13625187.2015.1107894. Epub 2015 Nov 17.Nappi RE, Kaunitz AM, Britzer J. Extended regimen combined oral contraception: a review of evolving concepts and acceptance by woman and clinicians. Eur J Contracept Reprod Health Care. 2016;21(2):106-15. doi: 10.3109/13625187.2015.1107894. Epub 2015 Nov 17.Collaborative group. Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Lancet Oncol. 2015 Sep;16(9): 1061-1070. doi: 10.1016/S1470-2045(15)00212-0. Epub 2015 Aug 4.Collaborative group. Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Lancet Oncol. 2015 Sep;16(9): 1061-1070. doi: 10.1016/S1470-2045(15)00212-0. Epub 2015 Aug 4.Collaborative group. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls. Lancet. 2008 Jan 26;371(9609):303-14. doi: 10.1016/S0140-6736(08)60167-1.Collaborative group. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls. Lancet. 2008 Jan 26;371(9609):303-14. doi: 10.1016/S0140-6736(08)60167-1.Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine validation study. Neurology. 2003 Aug 12;61(3):375-82. doi: 10.1212/01.WNL.0000078940.53438.83Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine validation study. Neurology. 2003 Aug 12;61(3):375-82. doi: 10.1212/01.WNL.0000078940.53438.83Eriksen MK, Thomsen LL, Olesen J. The visual aura rating scala (VARS) for migraine aura diagnosis. Cephalalgia. 2005 Oct; 25(10):801-10. doi: 10.1111/j.1468-2982.2005.00955.xEriksen MK, Thomsen LL, Olesen J. The visual aura rating scala (VARS) for migraine aura diagnosis. Cephalalgia. 2005 Oct; 25(10):801-10. doi: 10.1111/j.1468-2982.2005.00955.x

The authors declare that there are no conflicts of interest present.