Levonorgestrel
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Migraine exacerbation: case report A 39-year-old woman experienced exacerbation of migraine after following intra-abdominal migration of levonorgestrel-releasing intrauterine device (IUD) for contraception. The woman had been experiencing estrogen-associated migraines since 20 years of age. She had a typical migraine frequency on a monthly basis, prior to menstruation. She also had a history of exacerbation of migraines with use of estrogen-containing oral contraceptives [specific drug not stated]. During pregnancy and immediately postpartum, her migraine frequency temporarily increased to every other day. After delivery, she underwent placement of intrauterine levonorgestrel-releasing device [Mirena IUD; dosage not stated]. However, after 6 months postpartum, she presented to the clinic with sudden increase in migraine severity and frequency. The woman was treated with topiramate, sumatriptan and ketorolac [ketorolac tromethamine] resulting in mild relief. After examinations in the clinic, she reported severe abdominal pain. A workup revealed a perforated uterus with migration of her IUD into the omentum. Subsequently, her IUD was removed by laparoscopic procedure. After several months, she reported absent migraines since IUD removal and ongoing topiramate therapy. The intra-abdominal migration of levonorgestrel IUD was thought to cause exacerbation of migraines due to a possible increase in systemic absorption. Palmer K, et al. Migraine exacerbation after intra-abdominal migration of a levonorgestrel-releasing iud: A case report. Headache 60 (Suppl. 1): 21, Jun 2020. Available from: 803500879 URL: http://doi.org/10.1111/head.13854 [abstract]
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Reactions 12 Sep 2020 No. 1821
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