Women’s health update-relieving migraine and other pain

In this post I review some new drugs that treat conditions exclusive to or common in women.

I illustrated this post with covers of books written by women; I have reviewed all of these books on my blog, so I’ll include those links also. Please note these are affiliate links, so if you do happen to use them for a purchase you will help me fund this blog.

This information is current as of the publication date; it is general medical information that helps doctors and patients make decisions about what is right for them. Medical recommendations and practice changes as we learn new things. If you deal with any of these issues , please discuss with your doctor before taking any action.

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Relieving the pain of endometriosis

Women with endometriosis can suffer infertility, heavy menstrual bleeding, painful periods, and pelvic pain unrelated to their periods. In endometriosis, uterine tissue grows outside the uterus; laparoscopy, an invasive procedure us used to diagnose it. Treatment depends on the goal, whether pregnancy, pain relief, or both. Short of surgery, hormonal therapy has been the mainstay of treatment.

A new hormonal drug released in 2018, elagolix, brand name Orilissa, is the first of its kind specifically developed and approved to treat “moderate to severe” endometriosis pain, but not infertility. AbbVie, the pharmaceutical company which developed the drug,priced it at $844 per month, or about $10000 per year, retail.( per Reuters report) Patients may pay less depending on insurance.

 

Easing dyspareunia

After menopause many women develop atrophy of the vagina, making it thin, dry, and easily irritated, leading to painful sex, or dyspareunia. A new intravaginal medication, prasterone,brand name Intrarosa, can help relieve the discomfort. Studies show it may also help improve sexual desire and arousal, but it is not labeled for this.

Manufactured by AMAG Pharmaceuticals, it is for “moderate to severe” symptoms. Also known as DHEA, a steroid, it transforms into estrogen in the vagina; administered as a once daily vaginal insert at bedtime, applied with an applicator. According to goodrx.com, a 30 day supply costs about $213.

DHEA can be purchased as an over-the-counter, non-regulated product, whose effectiveness and safety are unknown. A one-month supply of 50 mg tablets may cost $5.

Other options for treating vaginal atrophy symptoms are oral or vaginal estrogen and/or vaginal lubricants.

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Prevention of migraine pain and disability

Migraine, although not exclusive to women,occurs more frequently in them than men. For infrequent headaches,doctors recommend non-prescription pain relievers since they are effective, safe, and have few side effects. For more severe and disabling headaches, prescription meds designed specifically for migraine are tried next, usually those in the triptan class of drugs.

But when headaches are severe, frequent, or persistent, patients should also consider preventive medication to improve quality of life. In addition to several effective oral meds there are two injectable drugs which work differently

The Food and Drug Administration has approved several new drugs in the past two years.

a new use for Botox

Yes the same drug used to treat wrinkles,Botox, can prevent migraine

Botox, onabotulinumtoxin A, treats chronic migraine, meaning patients with frequent headaches and other migraine symptoms for at least 3 months.

Manufactured by Allergan, a vial containing 200 units costs $1452, per goodrx.com. For migraine, the drug is injected in the upper facial muscles by a physician specifically trained in its use.

It’s in the genes

Another novel therapy uses the immune system to fight migraine.

Monoclonal antibodies bind to a calcitonin gene-related peptide receptor which transmits migraine pain. The antibodies are produced in a laboratory but work like antibodies naturally produced by the body. They are used to treat cancers and some forms of arthritis. They are called calcitonin gene-related peptide (CGRP) receptor antagonists.

These drugs are used to prevent migraine . (generic name-brand name)

  • Erenumab-Aimovig
  • Fremanezumab-Ajoovy
  • Galcanezumab-Emgality
  • Eptinezumab-Vyepti

 

Administered as subcutaneous injections (under the skin) monthly, according to Medscape, the average cost is $600 per month.

Two similar drugs, rimegepant (Nurtec ODT)and ubrogepant (Ubrelvy) treat migraine pain and are taken by mouth (orally).

You may want to review my previous post about non-drug ways to manage migraine.

Simple and effective ways to manage chronic pain

exploring the HEART of health through books

Thanks for joining me to review new steps in women’s health and review some fine women authors. I hope you will follow the links to my reviews and read some or all of these books. When you do, I would love to know your reaction. I might use your comments in an update.

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