Background: Dysmenorrhea and menstrual migraine may share a common pathogenic pathway. Both appear to
be mediated, in part, by an excess of prostaglandin production that occurs during menstruation.
Methods: Data were pooled from two replicate randomized controlled trials of 621 adult menstrual migraineurs
with dysmenorrhea who treated migraine with sumatriptan-naproxen or placebo. Along with headache symp-
toms, nonpain menstrual symptoms (bloating, fatigue, and irritability) and menstrual pain symptoms (abdominal
and back pain) were recorded at the time periods of 30 minutes and 1, 2, 4, and 4–24 hours. Relief of
menstrual symptoms was compared using a Cochran-Mantel-Haenszel test. Logistic regression was used to
determine the odds of a headache response with increasing numbers of moderate to severe dymenorrheic
symptoms.
Results: Sumatriptan-naproxen was superior to placebo for relief of tiredness, irritability, and abdominal pain at
the time periods of 2, 4, and 4–24 hours (p £ 0.023); back pain at the time periods of 4 and 4–24 hours
(p £ 0.023); and bloating at 4–24 hours endpoint (p = 0.01). The odds ratios (ORs) of attaining migraine pain
freedom for 2 hours and for sustained 2–24 hours decreased as moderate to severe dysmenorrhea symptoms
increased with sumatriptan-naproxen versus placebo.
Conclusions: Treatment with sumatriptan-naproxen may provide relief of menstrual symptoms and migraine in
female migraineurs with dysmenorrhea. The presence of moderate to severe dysmenorrhea symptoms is asso-
ciated with decreased response rates for menstrual migraine, suggesting that the co-occurrence of these disorders
may negatively impact the results of migraine-abortive therapy.
Background: Dysmenorrhea and menstrual migraine may share a common pathogenic pathway. Both appear to be mediated, in part, by an excess of prostaglandin production that occurs during menstruation. Methods: Data were pooled from two replicate randomized controlled trials of 621 adult menstrual migraineurs with dysmenorrhea who treated migraine with sumatriptan-naproxen or placebo. Along with headache symp- toms, nonpain menstrual symptoms (bloating, fatigue, and irritability) and menstrual pain symptoms (abdominal and back pain) were recorded at the time periods of 30 minutes and 1, 2, 4, and 4–24 hours. Relief of menstrual symptoms was compared using a Cochran-Mantel-Haenszel test. Logistic regression was used to determine the odds of a headache response with increasing numbers of moderate to severe dymenorrheic symptoms. Results: Sumatriptan-naproxen was superior to placebo for relief of tiredness, irritability, and abdominal pain at the time periods of 2, 4, and 4–24 hours (p £ 0.023); back pain at the time periods of 4 and 4–24 hours (p £ 0.023); and bloating at 4–24 hours endpoint (p = 0.01). The odds ratios (ORs) of attaining migraine pain freedom for 2 hours and for sustained 2–24 hours decreased as moderate to severe dysmenorrhea symptoms increased with sumatriptan-naproxen versus placebo. Conclusions: Treatment with sumatriptan-naproxen may provide relief of menstrual symptoms and migraine in migraineurs หญิง มีประจำเดือน ก็ปานกลางถึงอาการปวดประจำเดือนรุนแรงมี asso- ciated กับการตอบสนองลดลงและราคาพิเศษประจำเดือนไมเกรน แนะนำที่ผิดปกติเหล่านี้เกิดร่วม ในเชิงลบอาจส่งผลต่อผลลัพธ์ของการรักษาไมเกรน abortive
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