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Migraine and IUD

  • By RachelRoo

    Hi Everybody, this is my first post and I hope it is the right section of the forums.

    I have had migraines since I was a teenager/college student and they have gotten progressively worse over the years. Lately they are nearly daily (I am likely having some compounded MOH issues but that is another story) however they are much much worse when I am having my period. My OBGYN suggested last year that we do a year-round pill cycle, meaning we skip the ‘off’ pills to try to stop my period or limit it, but it still breaks through the birth control fairly frequently (every two months if not every month) and is excruciating, I almost always during that week need an abortive and a rescue for several days in a row, sometimes a steroid pack too. (I am on Topomax as a prophylactic, which -could- be messing with the pills some? though neuro and ob say the dose is low enough that it shouldn’t).

    My question is, have any patients here gone on a hormonal IUD to stop their period and found that it helped? I know that headaches can be a side effect of the Mirena and similar products but I assumed that was mostly for folks who didn’t already have chronic headaches. I feel like preventing menstruation would at least lessen that one set of intense headaches I get with the hormone cycle, but I wanted to know if anyone here had any personal experiences to share.

    Thanks so much!

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  • By Nancy Harris Bonk Moderator

    Hi RachelRoo,

    Before we talk about menstrual migraine I’d like to touch on moh if I may. As much as we’d like to consider moh ‘another story’ it really doesn’t work that way :(. Moh will most likely lead us down a path of endless daily pain and make our migraines more difficult to treat. Here’s the story – if we take migraine medications (abortives like Imitrex, Maxalt that stop the migraine process) and/or pain medications, whether they are over-the-counter or prescription, more than two to three days a week we can end up in an medication overuse cycle or moh. I’ve been here before it’s not pleasant. Stopping the offending medication is necessary to stop moh. Let me share information on this topic that I hope will be helpful; https://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/.

    To start off with here is information on ‘hormonal’ migraine from one of our migraine/headache disorder doctors; https://migraine.com/blog/hormonal-migraine-the-basics/. This information talks about birth control and migraine I hope helps; https://migraine.com/blog/birth-control-migraine-prevention/.

    Something else you may want to discuss with your doctor is taking Frova, a long acting triptan, prophylactically before menses. This is very helpful for some women with menstrual migraine. Continue reading this article for more information; https://migraine.com/blog/short-term-option-for-migraine-prevention-frova/.

    Let me know how you are doing,
    Nancy

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  • By Katie M. Golden Moderator

    Rachelroo,
    I personally got an IUD to rule out any hormonal issues related to my chronic migraines. I am using the copper IUD as opposed to the Mirena. The Mirena still has hormones in it, while the copper has no hormones. Overall, the less hormones used in your birht control, the less risk you have of it messing with your Migraines.

    For me, it didn’t make a huge difference, but my Migraines have never been tied to my menstrual cycle. While it didn’t help me, I do love the benefits of it. I take enough meds as it is, so this is just one less thing to worry about.

    -Katie

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  • By RachelRoo

    Thanks for your input everybody.

    My migraines are pretty chronic, but they are definitely worse around the time of my period. We’d put me on lose dose pill year round to try to help with that, but I had breakthrough periods almost monthly anyway. I’d been wondering whether to consider IUD as an option because it might be better at stopping menstruation altogether, but I wondered if that worked for anyone else. It seems like most of the internet just suggests the low dose bc pill which I am already taking.

    I don’t think the hormones in the birth control pill itself contribute though it would be hard to tell for sure…I did find I didn’t have nearly as many migraines when I was pregnant with my only child, but they were quick to return once she was born. (nor was I free of them entirely for the pregnancy, I actually found out I was pregnant while in the ER for yet another bad migraine. At least that visit had a happy part!)

    Thanks for your input everybody!

    -Rachel

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  • By Lisa Robin Benson Moderator

    Hi Rachel,

    I just got the mirena last January and as my periods become almost nonexistant, my menstrual migraines are less of a problem. However, my migraines have been improving in general so it’s hard to tell if that’s the only reason. If it may be a good choice for you otherwise, you could definitely consider it with your doctor. My doctor had said that is usually does not effect migraines, however, so it’s hard to know until you try.

    Best of luck,
    Lisa

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  • By RachelRoo

    Thanks for the information Lisa. I have an appointment early November with my OBGYN and am going to bring this up. Currently I am on the minipill (Minastrin) without breaks, and for a while it stopped my periods but it is no longer doing so…in fact, I’m getting breakthrough bleeding that seems like a full period any time. (My headache journal recorded my last period on October 6th…and I just got it again yesterday, along with another migraine. Fun!)

    I am also on Topomax, which may be contributing to the breakthrough bleeding, though my neurologist said that he wouldn’t be concerned. I’d been on Topomax and another low dose birth control pill for years and years, and only conceived when I was trying. At this point I have no idea what is going on with my horomones though, all I know is that it is not at all pleasant. I’m not interested in having any more children, but I am highly interested in lowering the frequency and intensity of my headaches. I’ve been reading some of these links and the Frova sounds promising too, but it also sounds like I need to get my periods regular so that my neurologist and I could predict when we’d need to start the dosing. So either regular periods, or no periods. I guess we’ll see what the OBGYN thinks…

    Thanks so much guys!

    Katie, with a copper IUD you do still menstruate, correct? Does it affect other PMS/period symptoms, like cramping and bleeding and body aches?

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  • By Katie M. Golden Moderator

    Rachel,
    I do still get my period on the copper IUD, however it’s very erratic. But then again, I was never very regular anyway. Also I never had horrible PMS symptoms so I guess I’m not the best one to give advice on if your periods and PMS would be the same.

    Sadly, figuring out how your body will react to major changes, especially with hormones, can take a while. I hope you get relief soon!
    -Katie

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  • By RachelRoo

    Just adding a follow up here, when I went to see the OBGYN she advised against the IUD. Aiming to make the periods stop altogether to avoid the menstrual migraines, she changed my pill to seasonique, another of the low dose pills, but this one on a continuous cycle. Basically the plan is to ignore the ‘inactive’ pills and just stay on the low dose of hormones in order to reduce and/or prevent my periods and therefore the particularly nasty migraines that come along with them.

    We’ll see!

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  • By Katie M. Golden Moderator

    Rachel,
    I’ve read a lot of literature that says women don’t actually need to have their periods. Seasonique might be very helpful.

    I would also like to add that my OBGYN was very much against the IUD. A friend my age has a similar story. She said she doesn’t do them for women who don’t have any children (which I don’t). I was very aware that I could have it removed and get pregnant. Just wanted to let you know that there are some old school docs that don’t like the IUD, in case you want to try it in the future.

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