Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis

BackgroundMigraine is highly prevalent in women (18%). Peak morbidity affects their most productive years, coinciding with peak fertility. Hormonal contraception is often tailored for migraine prevention. Estrogen-containing contraceptives may be contraindicated in women experiencing migraine with aura due to the risk of vascular events. While improvements in migraine with a progestin-only pill (POP), which inhibits ovulation are documented, the strength and quality of evidence has not been formally evaluated.ObjectivesTo determine the effectiveness of progestin-only contraceptives for migraine treatment by systematic review and meta-analysis.Data sources and selectionMEDLINE, EMBASE and Cochrane Libraries were searched (1980 to September 2016) for studies on progestin-only treatments for migraine. Studies in English on >4 non-menopausal women aged 18–50 with migraine diagnosed by formal criteria were included.Data extraction and analysisData were quality-assessed using the GRADE system. A random effects ...