Extended Cycle Ring Contraceptives as a Migraine Aura Reducer

A recent study by Calhoun, Ford, and Pruitt looked into the reduced frequency of migraine aura in women using extended-cycle ring contraceptives. It is known that expression of aura is directly related to estrogen concentration. As such, the researchers postulated that an extended cycle dosing of an ultra-low dose contraceptive which is capable of reducing a woman’s peak estrogen exposure would decrease the occurrence of aura in these women. It has previously been reported that in 81% of women taking a prescribed hormonal preventive that eliminated or reduced declines in estrogen experienced elimination of menstrual related migraine. Currently, the lowest-dose combined hormonal contraceptive available is a 15µg EE ring formulation. Extended use of this product results in consistent estrogen levels that are lower than the peaks of a native menstrual cycle. To evaluate their hypothesis that use of this ultra-low dose contraceptive would reduce the frequency of aura, the researchers did a retrospective review of a database of women at a menstrual related migraine clinic. The data collected from 23 of these women who met the study criteria showed that aura frequency decreased from an average of 3.5 auras/month to an average of 0.6 auras/month after 7.7 months of observation. It was also noted that menstrual related migraine was eliminated in 91.3% of the women. The data collected led the researchers to conclude that the use of extended cycle EE was associated with reduced frequency of aura and with the resolution of menstrual related migraine.