Migraines, Strokes and Birth Control Pills

Part of the Sexual Revolution

Back in the 1960s, when "the earth moved under my feet," the sexual revolution got its biggest boost from the development of "the Pill." This new form of birth control combined estrogen and progestin and, when taken every day, inhibited female fertility. Released by the US in 1960, the Pill quickly became the most popular way to circumvent pregnancy and now, more than 50 years later more than 100 million women worldwide current use the Pill or a form of it.

The Luster Fades

Over the years the magic of the Pill began to fade as women discovered the terrible side effects of taking a pill to skew their hormones. High-estrogen birth control pills are firmly linked to breast cancer, embolisms and strokes. Stroke risk in women who smoke and take birth control pills is especially high and can lead to ischemic and hemorrhagic strokes. Ischemic strokes are the most common type of stroke, caused by an interruption in the flow of blood to the brain by blood clot. Hemorrhagic stroke occurs when a blood vessel bursts inside the brain.

An increased risk of stroke rests in women who take birth control pills and have migraine headaches that are accompanied by an aura. Aura is a pleasant sounding word that represents a very disturbing neurological occurrence that usually happens 60 minutes prior to a migraine.

Flashing lights, spots, lines, or a total blackout where sight is temporarily lost are all part of a migraine aura. Other factors include numbness, tingling in the appendages, abdominal pain, vertigo, weakness on either side of the face, arm or leg, and even déjà vu.

How Birth Control Pills Affect Migraines

Migraine headaches are a part of life for many women. They usually begin at puberty and end at menopause. Most of these women find that the migraine symptoms get worse around the time of their period when estrogen levels decline and then are better when they finished their period.

A woman's natural cycle consists of the rising and falling of hormones, particularly progesterone and estrogen. Birth control pills work by keeping the estrogen levels high enough to trick the body into thinking it is pregnant and consequently pregnancy doesn't occur. When estrogen levels fall, migraines become worse.

When women who experience migraines use birth control pills, there is a concern that centers on the increased risk of stroke. Women who suffer with migraines are already at a higher risk for stroke, whether they use birth control pills or not, and especially if their migraines are accompanied by aura. Add cigarette smoking to the mix and you have an even higher risk level.

How Doctors Apply Birth Control Pills for Migraine Control

Some doctors recommend that women under the age of 35 who are not smokers and who experience "menstrual migraines" (those occurring prior to and during menses) use a method called extended dosing of birth control pills to help them. This method keeps the level of estrogen from declining, thus preventing a migraine.

It involves taking birth control pills continuously through the month, without taking the normal "active period" break, for a period of about three months. It also means there is no subsequent period. If the use of the pill in this manner causes an increase in frequency or intensity of the headaches, the woman stops taking the pill.

Another method of preventing the menstrual estrogen drop that is used by physicians is the use of an estrogen patch during the week of abstaining from the pill. Women migraine sufferers who are not on the pill are sometimes prescribed the patch to be worn just before their menstrual period. Keeping the level of estrogen up may help to alleviate menstrual migraines.


It is possible for headaches to improve with extended dosing of birth control pills. However, the American College of Obstetricians and Gynecologists and the World Health Organization add this restriction: If you have a migraine with aura, don't use birth control pills before consulting a headache specialist.

And, under no circumstances should you take birth control pills if you smoke and have migraines of either type. If you suffer from tension-type headaches, however, there is no contraindication to use of birth control pills.


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