After oophorectomy, most women need hormone replacement therapy anyway, she tells patients. For patients who have hormonal abnormalities, Dr. Geweke suggested starting with a standard regimen of oral contraceptives, switching to continuous oral contraceptives with quarterly withdrawal if the patient continues to have headaches at the time of menses. Estrogen replacement therapy is sometimes prophylactic for these patients, Dr. Geweke said. It should be administered intermittently on the same schedule as for other menstrual migraine prophylactics. Dr. Geweke commented that she considers danazol, tamoxifen, bromocriptine and gonadotropin-releasing hormone to be last resorts.
Many women get better, but others get worse.
The woman needs to be told what might happen, and if things don't go right, she needs to be supported until things straighten around again. Inc. All rights reserved. This site produced by the Journal of the American Medical Association . 1998 American Medical Association. All rights reserved.