***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To evaluate the efficacy and safety of sumatriptan , a 5-HTa receptor agonist , in patients with menstruationassociated migraine . Methods : Two double-blind , placebo-controlled , singleattack parallel group studies of subcutaneous sumatriptan were conducted for the acute treatment of migraine . A retrospective analysis of 1104 patients produced 157 women who were treated for a menstruation-associated migraine ( defined as a migraine beginning between 1 day before and 4 days after the onset of menstrual flow ) and 512 women treated for nonmenstrual migraine . We excluded 435 other patients who were either male ( 123 ) , women with hysterectomies ( 260 ) , or women with missing data ( 52 ) . Patients with moderate or severe pain were treated with 6 mg subcutaneous sumatriptan or placebo . One hour after treatment , response rates of headache severity and associated symptoms were measured . Menstruation-associated migraine patients were compared to female patients with nonmenstrual migraine . Migraine recurrence was analyzed retrospectively for 24 hours . Results : At 1 hour , 80 % of the sumatriptan-treated menstrual-migraine patients had pain relief ( reduction of severe or moderate pain to mild or no pain ) , compared to 19 % of the placebo patients ( P < .001 ) . Sumatriptan also treated nausea and photophobia more effectively in menstrual-migraine patients than did placebo .  Response rates for pain and associated symptoms were similar between patients with menstruation-associated and nonmenstrual migraines . Adverse effects were also similar between the groups . Conclusion : Sumatriptan was as effective and well tolerated for menstruation-associated migraine as it was for nonmenstrual migraine OBJECTIVES To determine the preventive benefit of " medical oophorectomy " and transdermal estradiol in women with migraine . BACKGROUND Epidemiological studies have demonstrated that declines in serum estrogen levels occurring during normal menstrual cycles can trigger headache in women with migraine . Prior to this study , no r and omized controlled trials have evaluated whether minimizing these hormonal changes pharmacologically can prevent headache . METHODS Twenty-one women with regular menstrual cycles and a diagnosis of migraine headache were enrolled . After a 2.5-month placebo run-in phase , all patients received a subcutaneous goserelin implant ( a gonadotropin-releasing hormone agonist ) to induce a medical oophorectomy . One month later , while continuing goserelin , participants were r and omized to receive a transdermal patch containing 100 microg of estradiol-17beta ( gonadotropin-releasing hormone agonist/estradiol group , n = 9 ) or a placebo patch ( gonadotropin-releasing hormone agonist/placebo group , n = 12 ) during a 2-month treatment phase . The primary outcome measure was the headache index , which was defined as the mean of pain severity ratings ( 0 to 10 scale ) recorded three times per day by daily diary . Secondary outcome measures included headache disability , headache severity , headache frequency , and the percentage of headaches with a pain severity rating of 7 or greater . RESULTS The headache index was significantly lower during the treatment period in the gonadotropin-releasing hormone agonist/estradiol group than in the gonadotropin-releasing hormone agonist/placebo group ( P = .025 ) . Similar improvements were observed in the gonadotropin-releasing hormone agonist/estradiol group for all secondary outcome measures with the exception of headache frequency , which was unchanged between the groups . Within the gonadotropin-releasing hormone agonist/estradiol group , there was a 33.7 % reduction ( 95 % confidence interval , -64.4 to -3.0 ) in the headache index during the treatment phase when compared with the placebo run-in phase ; no difference was seen between those phases within the gonadotropin-releasing hormone agonist/placebo group . CONCLUSIONS Minimization of hormonal fluctuations with gonadotropin-releasing hormone agonist therapy alone is inadequate to prevent headache in women who are premenopausal with migraine . The addition of transdermal estradiol to existing gonadotropin-releasing hormone agonist therapy provides a modest preventive benefit These are the first prospect i ve studies to use criteria for menstrual migraine proposed in the 2004 revision of the International Classification of Headache Disorders ( ICHD-II ) to examine the efficacy of rizatriptan for treatment of a menstrual attack . Two identical protocol s ( MM1 and MM2 ) were r and omized , parallel , placebo-controlled , double-blind studies . Adult women with ICHD-II menstrual migraine were assigned to either rizatriptan 10-mg tablet or placebo in a 2 : 1 ratio . Patients treated a single menstrual migraine attack of moderate or severe pain intensity . The primary end-point was 2-h pain relief and the secondary end-point was 24-h sustained pain relief . A total of 707 patients ( MM1 357 , MM2 350 ) treated a menstrual migraine attack . The percentage of patients reporting 2-h pain relief was significantly greater for rizatriptan than for placebo ( MM1 70 % vs. 53 % , MM2 73 % vs. 50 % ) , as was the percentage of patients reporting 24-h sustained pain relief ( MM1 46 % vs. 33 % ; MM2 46 % vs. 33 % ) . Rizatriptan 10 mg was effective for the treatment of ICHD-II menstrual migraine , as measured by 2-h pain relief and 24-h sustained pain relief Two r and omised , double-blind , parallel-group , placebo-controlled clinical trials were conducted to assess the efficacy of sumatriptan tablets , 50 mg and 100 mg , for treatment during the mild-pain phase of a menstrually associated migraine among patients who typically experienced moderate to severe migraine preceded by an identifiable phase of mild pain . Subjects ( n = 403 in Study 1 and n = 349 in Study 2 ) treated one menstrually associated migraine on an outpatient basis . The results demonstrate that sumatriptan tablets , 50 mg or 100 mg , were significantly more effective than placebo at conferring pain-free response 1 h and 2 h post-dose ; migraine-free response ( i.e. no pain and no associated symptoms ) 2 h post-dose ; returning patients to normal functioning 2 h post-dose ; and conferring sustained freedom from pain from 2 through 24 h post-dose . Although the studies were not design ed or statistically powered to show differences between the sumatriptan doses , a trend for slightly higher efficacy was observed for the 100-mg dose compared with the 50-mg dose on many measures . Both doses of sumatriptan were well-tolerated . The only adverse events reported in more than 2 % of subjects in a treatment group were nausea , paresthesia , dizziness and malaise/fatigue , all of which were reported at incidences comparable to or slightly higher than those with placebo . Considered in the context of other findings , these data suggest that -- with menstrually associated migraine as with non-menstrual migraine -- optimal therapeutic benefit of sumatriptan tablets may be realised when they are administered during the mild-pain phase of an attack rather than delaying treatment until headache is moderate or severe Objective To determine the efficacy of oral rizatriptan 10 mg and 5 mg for treating  menstrually associated migraine attacks .  Methods Data from two large clinical trials with identical design s were included in a retrospective analysis . The studies were r and omized , double-masked , placebo-controlled , incomplete block , two-period , crossover design s. Women with migraines were r and omly assigned to one of five treatment sequences for the treatment of two migraine attacks . Only data from the first attack in women with migraines who were treated with rizatriptan or placebo  were included in the analysis . A menstrually associated attack was defined as one that occurred within 3 days before or after the onset of the last menstrual period . Results In the subgroup of 335 women with menstrually associated migraine , rizatriptan was effective compared with placebo . At 2 hours after dosing , 68 % of 139 women taking rizatriptan 10 mg and 70 % of 115 women taking rizatriptan 5 mg with a menstrually associated migraine had pain relief compared with 44 % of 81 patients taking placebo ( P < .05 ) . In all women , rizatriptan was as effective in treating menstrual as well as nonmenstrual migraine : 68 % of 139 patients taking rizatriptan 10 mg with a menstrually associated migraine had pain relief at 2 hours after dosing compared with 69 % of 393 patients with nonmenstrually associated attacks ( test of menstrual association = nonsignificant ; the analysis had 80 % power to detect a difference of six percentage points between groups ) . Similar results were found for rizatriptan 5 mg ( menstrual = 70 % , nonmenstrual = 66 % ; not statistically significant ) . Conclusion Rizatriptan is effective in the treatment of menstrually associated migraine attacks The objective was to evaluate the efficacy and tolerability of oral sumatriptan ( 100 mg ) in patients who self – reported with menstrually related migraine . A prospect i ve , multicentre , r and omised , double – blind , placebocontrolled , two – group crossover study was carried out in 20 UK primary and secondary care surgeries . Of 115 patients with a self – reported history of menstrually related migraine that entered the study , 93 patients completed it . Patients treated all migraine attacks for 2 months with sumatriptan ( 100 mg ) and for 2 months with placebo . The primary endpoint was the proportion of patients reporting headache relief at 4 hours for the first treated attack . Only 11 % of patients fulfilled the protocol definition of menstrually related migraine . Patients reported a variable pattern of migraine attacks occurring inside and outside the menstrual window . For the first attack , significantly more patients receiving sumatriptan than placebo  reported headache relief for attacks occurring inside ( 67 % vs. 33 % , p=0.007 ) and outside ( 79 % vs. 31 % , p<0.001 ) the menstrual period . Sumatriptan was generally well tolerated . Oral sumatriptan ( 100 mg ) is an effective and well tolerated acute treatment for patients who report menstrually related migraine SYNOPSIS Objective .—To determine the efficacy of naratriptan 1‐mg and 2.5‐mg tablets twice daily compared with placebo as short‐term prophylaxis of menstrually associated migraine The present study investigated whether administration of percutaneous estradiol for the 7 days encompassing menstruation ( the paramenstruum ) would be effective in alleviating  menstrual migraine .  The study was a double-blind cross-over placebo comparison of percutaneous estradiol in gel form . Twenty-two women who suffered from regular recurring menstrual migraine were studied during 2 assessment menstrual cycles , 4 treatment cycles ( 2 of estradiol gel , 2 of placebo gel ) , and 1 follow-up ( no treatment ) cycle . Women completed daily records of the occurrence and severity of migraine and medication used .  Eighteen women completed the study . There was a significant reduction in the frequency of migraine in the paramenstruum and in the amount of medication taken during use of percutaneous estradiol . Women expressed a significant preference for continuation of therapy with percutaneous estradiol Abstract Objective : To determine the efficacy and tolerability of zolmitriptan 2.5 mg oral tablet as an acute treatment for menstrual migraine attacks . Methods : This was a two-phase , multicentre , r and omised , double-blind , placebo-controlled , parallel-group outpatient study ( phase I is reported here ) . The study was conducted at 27 sites in the USA . Eligible women were r and omised ( 1 : 1 ) to receive either zolmitriptan 2.5 mg oral tablet or placebo  , and instructed to acutely treat up to two menstrual migraine attacks per menstrual period for up to three menstrual cycles with a single dose of study medication . Menstrual migraine was operationally defined as an attack occurring within the time period of 2 days prior to the expected onset of menses to 5 days after the onset of menses . Participants were asked to treat migraine headaches of moderate or severe intensity only that occurred > 24 hours after the end of the last migraine attack and that had not been acutely treated with other medications . Information regarding each migraine attack was recorded by patients in treatment diary cards . The primary efficacy variable was 2-hour headache response ( defined as a 2-point drop on a 4-point scale ) for all attacks treated . Secondary variables included 1- and 4-hour headache response rate ; 1- , 2- and 4-hour headache response based on a 100 mm visual analogue scale ( VAS ) ; pain-free rate at 1 , 2 and 4 hours ; use of escape medication ; the proportion of patients with recurrence within 24 hours of initial treatment ; and tolerability . Results : The intention-to-treat population comprised 334 patients ( zolmitriptan  [ n = 174 ] ; placebo [ n = 160 ] ) . Patients treated 6 
    Output:
    
Based on the evidence , grade B recommendations can be made for the use of sumatriptan 50 and 100 mg , mefenamic acid 500 mg , and rizatriptan 10 mg for the acute treatment of MRM .