Expert Answer: Birth Control & Migraine Prevention
Question: Can birth control help treat my migraines? Is there a particular type of birth control I should consider? If it helps, will I have to keep taking the treatment forever for my migraines?
Birth control in the form of oral contraceptive pills or the contraceptive ring (brand name Nuvaring) can help women who have a hormonal trigger to their migraines. However, there is no guarantee that birth control will lessen migraine; there is a chance that birth control can worsen migraine. Therefore, keeping a headache calendar to track the pattern of migraines before and after birth control is important.
The type of birth control most likely to help migraine is a low dose formulation (30 mcg or less of ethinyl estradiol) of the pill (or the Nuvaring) used in a continuous manner, i.e. using continuously to maintain an even or steady-state level of estrogen and only cycling off approximately every 3-6 months.
It is important to be screened to make sure contraception is safe since there is an increase risk in stroke in women who smoke or have high blood pressure and who take contraception; this risk is increased in women who have migraines especially if it is migraine with aura.
Lastly, even if a woman finds birth control helpful in preventing her migraines, she does not have to take the treatment forever. As we age, our needs for hormones change. Also, other treatments including non-hormonal medications and non-pharmacologic treatments including a healthy life-style and herbal preventives may make continued use of birth control unnecessary.
In summary, birth control can help some women with migraine but may worsen migraine in other women. It may be worth trying but careful attention to the headache pattern is needed to monitor the effect.
When it comes to planning vacations or other events where travel is required, how much does migraine factor into your decision-making?