Hormone Therapy Is A Safe Option for Women With Migraines

Hormone therapy was not associated with an increased risk for cardiovascular disease (CVD) among women with migraines, according to the findings of a recent study. These results, presented at the North American Menopause Society Annual Meeting, indicates that hormone therapy may be safe for postmenopausal women with a history of migraine.

Currently, combined oral contraceptives are not recommended for women with migraine with aura due to the association between estrogen use and increased risk of stroke. However, the effects of hormone therapy on migraine and CVD risk have not been extensively examined.
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In their study, the researchers analyzed the association between migraine and CVD and whether hormone therapy modified the relationship using data from the Women’s Health Initiative Observational Study (WHI-OS) and Hormone Therapy trial cohorts (HT). Migraine status was reported at baseline and CVD outcomes included myocardial infarction, deep vein thrombosis, pulmonary embolism, stroke, angioplasty of coronary arteries, coronary bypass surgery, and coronary heart disease.

Of the 67,903 women from the WHI-OS cohort, 7322 participants (10.8%) had a history of migraine, with 45.1% reported by women from 50 to 59 years. Women with migraine were more likely to drink, exercise less, and have higher vitamin D and calcium intake. Additionally, women with migraine were more likely to experience night sweats and hot flashes. However, the researchers did not find an increased risk of incident composite CVD events among women with migraine compared with those without migraine (hazard ratio [HR] 1.04).

Among the 17,357 participants from the HT cohort, 1482 reported a history of migraine. The researchers observed a non-significant decrease in composite CVD events among participants with migraine (HR 0.71). However, hormone therapy was not found to modify the relationship between migraine and composite CVD in comparisons of women with migraine who received hormone therapy and those who received placebo (HR 1.04).

“We did not detect significant risk of incident composite CVD events associated with history of migraine in this longitudinal cohort of older postmenopausal women. Furthermore, hormone therapy was not an effect modifier of this relationship,” the researchers concluded. “As migraine is highly prevalent in the population and women with migraine are often advised to avoid [hormone therapy], these findings may have significant public health implications. Further work should be done on exploring different categories of CVD events in different subpopulations of women with migraine.”

—Melissa Weiss

Reference:

Pavlovic J, Hedlin H, Yang J, Jiang X, Robbins J, Schnatz PF. The relationship between migraine, cardiovascular disease (CVD) and hormone therapy (HT) in postmenopausal women in the Women’s Health Initiative Study (WHI). Present at: The North American Menopause Society Annual Meeting. Philadelphia, PA; October 11-14, 2017. Abstract S-13.