Migraine & Estradiol Pellets

Edward Lichten, M.D.,PC
189 Townsend - 2nd floor
Birmingham, MI 48009 


Estradiol Subcutaneous pellet for the definite diagnosis and treatment of hormonal migraine

Cepahalgia 1999;19(4):332

Edward M. Lichten, M.D.. P.C.
Providence Hospital, Southfield, Michigan USA

Objectives. To evaluate the effectiveness of the subcutaneous estradiol pellet in the prevention of hormonal migraine.

Materials and Methods. A double-blinded cross-over study was performed in women with incapacitating menstrual migraine in whom all forms of conventional therapy had failed including propranolol, calcium-channel blockers, sumatriptan, and amitryiptyline. Migraine was defined according to IHS criteria. Cervicogenic components were eliminated. Serum estradiol assays were performed on the day of or after occurrence of migraine. Estradiol pellets or placebo were inserted and migraine occurrence was documented for the 2-month half-life of the 50 mg estradiol pellets. After the 2-month washout period, crossover occurred.

Results. In total, 30 patients with migraine were included from a population of 137 women. Of these, 27 reported complete prevention of their most severe migraines while on the estradiol pellets; severe migraines recurred while on the placebo. Three women reported no relief with any therapy. The average estradiol level was 53 mg/ml higher in the group on estradiol pellets who experienced no migraines.

Conclusions. The physiology of women's migraine is based on dropping estrogen levels. By using the estradiol measurements to diagnose the cause of migraine and the estradiol subcutaneous pellet to treat, future physicians will find estradiol to be the most effective preventative therapy for this devastating disorder.