Dr. Sulak, obstetrician/
gynecologist at Scott & White and professor at Texas A&M Health Science Center College of Medicine, said it’s only normal she would be interested in preventing migraines in women, since she takes care of women in her practice.
Of the 28 million people in the United States who have migraine headaches, 21 million are women, Dr. Sulak said. Sixty percent of those headaches in women occur around the time of their periods.
The menstrual headache is the worst type of migraine because it lasts longer, is more severe and more difficult to treat, Dr. Sulak said.
There are other health problems associated with a woman’s period - cramps, heavy bleeding and premenstrual syndrome.
The economic impact of this health issue is great and not only includes the money spent on medication, but loss of productivity at work, she said.
“We’re spending billions on prescription and over-the-counter medications,” she said.
Menstrual migraines usually begin a couple of days before the period or at the beginning of the menstrual cycle because of the fluctuation in the woman’s hormone levels.
“These headaches take place when the hormone levels, particularly estrogen, begin to drop,” Dr. Sulak said. “These are estrogen withdrawal headaches.”
This problem is also experienced by women on birth control pills because many women take the pills for 21 days and are off for seven. It’s during those seven off days the headaches take place.
“At Scott & White we’ve been instrumental in redesigning birth control pills to get rid of the headaches and the problems associated with birth control pills,” Sulak said.
Many of those who now take birth control pills continuously, without the seven-day break, no longer suffer from cramps, PMS or headaches, Dr. Sulak said.
This single center study was designed by Sulak and Dr. Thomas Kuehl, director of OB/GYN research division at Scott & White.
Scott & White physicians began recognizing the problem in the 1990s and published their first article in a medical journal in 2000.”
“My job as a gynecologist is try to improve the health of women in various ways and to make sure I’m not harming their health,” she said. “We’re looking at whether we can reduce a number of debilitating monthly problems by reducing the number of periods women have per year.”
The periods are not completely eliminated, Dr. Sulak said.
There are those who believe reducing the number of periods women have in a year would be unhealthy, but it’s not, she said.
Women were not biologically designed to have 12 periods a year, Dr. Sulak said.
“We were designed to have a bunch of kids and breast feed,” she said. “Women are now having more periods year after year after year. They’re developing menstrual problems. They’re developing endometriosis, which can lead to infertility. They’re getting cysts on their ovaries, and fibroid tumors on their uteruses.”
Through studies, it’s been discovered the woman’s uterus and ovaries can be protected by using birth control pills to reduce the number of periods.
The last five types of birth control pills approved by the FDA have not been the typical 21 days of hormones and seven days of placebos, she said.
In the Scott & White study the women will be given pills to eliminate their period for a number of months. There will be a break when the women go off the pill for four days and during that time the study subjects will be given frovatriptan, an FDA approved medication to prevent headaches.
“Frovatriptan has traditionally been used to stop a migraine once it has started, but may also help to prevent migraine at specific times during menstrual cycle if given before the headache begins,” said Dr. Jeffrey Clark, a neurologist and associate professor at Scott & White. “By combining continuous oral birth control pills with preventive frovatriptan we expect to significantly decrease headache frequency and severity in women with documented menstrual migraine.”
The hope is to get 40 ideal study candidates, who have headaches around the time of their period, in place during the next three months, Dr. Sulak said. To get to that 40, many more will have to be enrolled.
The study will last eight months and will include free medication, an appointment with a board certified neurologist and a stipend for time and travel.
Interested women, age 18 to 45, may get information on this study by calling 254-724-1350 or by sending an e-mail to obgynresearch@swmail.sw.org
