Hormonal birth control use

Hormonal contraception can change headache patterns. It can improve headaches in some people but make them worse in others. Hormonal contraceptives include birth control pills, patches or vaginal rings.

Birth control may help relieve headaches by minimizing the drop in estrogen that happens during a period. You may have fewer migraines. Or your migraines may be less severe.

Using hormonal birth control to prevent migraines may be appropriate if you don't smoke and if you don't have migraine with aura. But if you smoke or experience aura, discuss this with your health care provider before starting birth control that contains estrogen.

Migraine with aura means having nervous system symptoms before or during a migraine. You might see flashes of light or notice blind spots in your vision. Or you may have other vision changes. You might feel tingling in your hands or face. Rarely, migraine with aura can cause trouble speaking or using language. In rare cases it can cause weakness on one side of the body. If you have migraine with aura, talk to your health care provider. If you have new spells of visual changes, sensory changes, weakness or trouble speaking without a migraine, seek medical care right away. This is true especially if you haven’t experienced these symptoms before.

If you have a history of migraine with aura, it's important that you don't take estrogen if you smoke. Smoking while taking birth control that contains estrogen puts you at higher risk of having a stroke.

While birth control can help relieve headaches for some, it may trigger headaches for others. But headaches might only occur during the first month of taking birth control. Talk to your health care provider if this happens to you.

If birth control seems to cause your headaches, your health care provider might recommend:

• Using a monthly birth control pill pack with fewer placebos. Placebos are pills that don't contain hormones.
• Stopping the placebo days completely for most months. This can be done by taking extended-cycle estrogen-progestin birth control pills (Loseasonique, Seasonique).
• Using birth control pills that have a lower dose of estrogen. This helps reduce the drop in estrogen during the placebo days.
• Taking NSAIDs and triptans during the placebo days.
• Taking a low dose of estrogen pills or wearing an estrogen patch during the placebo days.
• Adjusting your use of a birth control patch. If you use a birth control patch during three weeks of the month, use a skin patch that contains estrogen on the fourth week.
• Taking the minipill. If you're not able to take estrogen-progestin birth control pills, the minipill norethindrone (Camila, Heather, others) contains progestin but not estrogen.