{"id":18594,"date":"2021-03-03T09:30:14","date_gmt":"2021-03-03T14:30:14","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=18594"},"modified":"2024-05-15T17:15:20","modified_gmt":"2024-05-15T21:15:20","slug":"migraine-and-birth-control","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/migraine-and-birth-control\/","title":{"rendered":"Migraine with aura and birth control pills: A dangerous combination?"},"content":{"rendered":"

My first migraine with aura was in seventh grade. I\u2019d had a sleepover with my best friend, Jessica, and we\u2019d eaten donuts for breakfast. After her mom picked her up, I started feeling weird, spacy, sickly. Soon, I couldn\u2019t see and my hand was numb. My head started to pound. I was having trouble forming words to describe my symptoms. My mom put me to bed and called our pediatrician. It was a Sunday, and there was a particularly bad flu that year. They told her to only call them if I stopped breathing. I threw up and felt okay after. I stayed home from school the next day and didn\u2019t have any more symptoms. We chalked it up to a bug.<\/span><\/p>\n

<\/span><\/span><\/p>\n

But then it happened again. And again. Sometimes only one side of my body would go numb. I couldn\u2019t swallow pain pills at that age and couldn\u2019t feel my tongue anyway. I had aphasia (a loss of ability to understand speech) and the pain was worse than a normal tension headache.\u00a0<\/span><\/p>\n

My migraine diagnosis<\/b><\/h2>\n

I went back to the pediatrician after the third incident and she told me my headaches were classic migraines and the vision issues were an aura. The aura looks different for each person and, at least for me, looks different each migraine, but the basic idea is that you have too much blood rushing to your head and it impedes your vision. There are two main kinds of aura with migraine: positive symptoms (flashing lights, spots, lines, pins, needles) and negative symptoms (numbness, hemi-paralysis, visual loss). For me, it looks like the visual imprint when you look at backlit Venetian blinds or when you accidentally stare into the sun\u2019s reflection in a shiny object. Learning to identify an aura was key to figuring out what was going on with me.<\/span><\/p>\n

\u201cMigraine headaches are<\/span> the third most prevalent illness in the world<\/span><\/a>,\u201d explains Queen Buyalos, <\/span>R.Ph.<\/span>, creator of <\/span>Mommy Queendom<\/span><\/a>. \u201cLow estrogen or high estrogen can cause migraines.\u201d Because mine had an aura, they were likely caused by high estrogen.<\/span><\/p>\n

I was prescribed the migraine medication <\/span>Imitrex (sumatriptan)<\/span><\/a> in different forms over the years, but the one that is dissolvable on the tongue was the one I took most frequently. Caffeine or over-the-counter caffeine pain killers like Excedrin often made the symptoms less severe if I took it early or chugged a cup of black coffee.<\/span><\/p>\n

RELATED: <\/b>More migraine treatments and medications<\/b><\/a><\/p>\n

Uncovering a dangerous combination\u2014migraine with aura and estrogen-containing birth control pills<\/b><\/h2>\n

In college, I went on a birth control pill (that contained <\/span>estrogen<\/span><\/a> and progesterone) and took one brand or another for the next 10 years. By now, my childhood friend Jessica was in med school and called me one day in a panic.<\/span><\/p>\n

\u201cDo you still get migraines with aura?\u201d she asked.<\/span><\/p>\n

\u201cYes.\u201d<\/span><\/p>\n

\u201cDo you still take birth control pills with estrogen?\u201d<\/span><\/p>\n

\u201cYes.\u201d<\/span><\/p>\n

\u201cYou need to get off those immediately. You could have a stroke.\u201d<\/span><\/p>\n

I thought she was being dramatic. There\u2019s this thing called student doctor syndrome where med students think they or their loved ones have the diseases they\u2019re studying. But, just in case, I mentioned it at my next gynecologist appointment.<\/span><\/p>\n

\u00a0<\/span>Sure enough, I should not have been taking hormonal birth control with estrogen. I\u2019d had a grandparent on each side die of stroke-related complications and still occasionally got migraines with aura. Jessica knew all of this family and personal health history and potentially saved my life. I was at high risk for a stroke now or in the future.\u00a0<\/span><\/p>\n

\u201cT<\/span>he estrogen component of the contraceptive poses a risk for the individual because it can induce and exacerbate menstrual\/hormone-related headaches as well as makes the blood more easily clot,\u201d explains <\/span>Christina Madison, Pharm.D., <\/span>an associate professor of pharmacy practice at the Roseman University of Health Sciences \u2013 College of Pharmacy.<\/span> \u201cThis is of particular risk for persons with a history of migraine headaches with aura (the most severe form) because it can cause worsening of the condition and increase the risk of stroke.\u201d Estrogen containing contraception is only contraindicated in the case of migraine with aura. Common migraine, or migraine without aura, is not a contraindication for contraception that contains estrogen.<\/span><\/p>\n

My student health center had prescribed the estrogen-containing hormonal birth control in the first place and probably hadn\u2019t caught the history of migraine with aura. It\u2019s possible I hadn\u2019t mentioned it since I didn\u2019t know it was a relevant detail. I\u2019m sure I hadn\u2019t mentioned the family history of stroke in my intake. I was slightly concerned, though, that none of my doctors had caught it since. This is just one example of how important it is to share a complete family and medical history with all of your healthcare providers\u2014especially gynecologists.<\/span><\/p>\n

As it happened, I was visiting my gynecologist to talk about next steps before getting pregnant, so I simply stopped taking that form of hormonal birth control when my cycle ended and got pregnant quickly.<\/span><\/p>\n

Migraine-safe birth control options<\/b><\/h2>\n

After my daughter was born, I visited my primary care provider to discuss all of my options now that birth control with estrogen was no longer an option.\u00a0<\/span>\u00a0<\/span>
\nShe said I could take the progestin-only pill (sometimes called the POP of mini pill) without worrying about stroke; however, I\u2019d learned that the POP was somewhat particular in that you have to take it at the same time every day or else it\u2019s not effective.\u00a0<\/span><\/p>\n

If that\u2019s a worry for you, there are many <\/span>non-estrogen forms of birth control <\/span><\/a>\u00a0that are safe for those who have migraines with aura including:<\/span><\/p>\n