Murray SC. Muse KN.


Dr. S.C. Murray, Department of Obstetrics/Gynecology, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0084; United States. E-Mail:


Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and 'add-back' therapy (1997-2025).


Fertility and Sterility. Vol 67(2) (pp90-393), 1997.



To determine the efficacy of treating women with severe menstrual migraine headaches with GnRH agonist (GnRH-a) therapy, alone and combined with continuous estrogen-progestin 'add-back.'


Nonrandomized, prospective treatment study.


Outpatient clinic in a university medical center.


Five women who had repetitive, severe, migraine headaches limited to the perimenstrual period were selected carefully.


After 2 months of basal evaluation, all subjects received GnRH-a (leuprolide acetate depot formulation, 3.75 mg IM, monthly) for 10 months. Beginning with the 5th month, 'add-back' therapy (the addition of transdermal E2, 0.1 mg daily, and oral medroxyprogesterone acetate, 2.5 mg daily) was initiated.

Main Outcome Measure(s):

Patients rated headache severity from 0 (absent) to 3 (severe) each day; these were combined each month to obtain a cumulative score for that month. In addition, patients were asked their overall assessment of the treatments.


The mean headache scores for the GnRH-a treatment months (4.0 +/- 1.5, mean +/- SEM) and for the GnRH-a and 'add-back' treatment months (3.1 +/- 0.7) were each significantly lower than those of the control months (15.3 +/- 24). The patients uniformly found both treatments to be well tolerated and near- curative for their condition.


Gonadotropin-releasing hormone agonist administration, alone or with 'add-back' therapy, is a very effective treatment for carefully selected patients with severe, perimenstrual migraine headaches.

Women's Health

Back Home Up Next -checksum="58631" ends

Please click on the required question.

Women's Health

Thank you for choosing to visit us.

This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.

David Viniker retired from active clinical practice in 2012.
In 1999, he setup this website - - to provide detailed
information many of his patients requested. The website attracts thousands of visitors every day from around the world.
Website optimisation (SEO) has became more than an active hobby. If you would like advice on your website, please visit his website Keyword SEO PRO or email him on
David Viniker Linkedin Profile