Migraine is the third most common disease in the world, and the sixth most debilitating illness worldwide. This recurring form of headache takes form in a multitude of different types, most commonly, migraine with aura and migraine without aura. Of the 40 million Americans suffering from migraine, 28 million are women.
How are Migraines and Birth Control Related?
More than half of the 28 million women who experience migraine often note suffering from menstrual migraines. This type of migraine is triggered by menstrual hormones, which only occur near or during a period.
Meanwhile, many women take birth control to regulate their menstrual cycles and the symptoms they experience alongside them. Hormonal medications, including birth control pills, patches, and intrauterine devices work to steadily introduce hormones into the body, and therefore, control periods and many other menstrual-related symptoms.
Since birth control regulates hormones, it’s not surprising that many women report a significant decrease in the frequency and pain intensity of their migraines when using birth control. Unfortunately this is not the case for all women, as some actually note an increase in their migraines due to birth control. This is likely due to the synthetic estrogen that birth control supplies: some bodies react positively while others react negatively, specifically women with a history of migraine with aura.
How Birth Control Could Prevent Migraines
Birth control works by regulating the body’s hormone levels, building mucus in the uterus to block the passage of sperm, and pause ovulation. A common migraine trigger, especially for women with menstrual migraines, is a sudden drop or increase in hormone levels, specifically estrogen. Birth control, in its many forms, can help regulate hormone levels and lead to a decrease in migraines.
Birth Control: The Pill
Birth control pills, often referred to as The Pill, is a form of hormonal contraception. Orally taken once per day, women use this form of birth control to inhibit ovulation, prevent pregnancy, and maintain estrogen levels. The Pill is known as a continuous form of contraception, meaning you must manage your intake of the pill, daily, in order to maintain estrogen levels.
There are two types of oral contraception, and both work to prevent pregnancy and maintain estrogen levels
This form of oral contraception contains a combination of two female sex hormones; estrogen and progestin, the synthetic form of proestrogen. Different types of combination birth control pills contain different levels of estrogen and progestin. The appropriate levels of both sex hormones should be determined by a medical professional. But, a low dosage of estrogen and progestin is recommended for migraine prevention, as too much could lead to an increase in migraine frequency and pain.
For women who shouldn’t take estrogen pills, including women who have a history of blood clots and strokes, as well as women who are breastfeeding, many doctors recommend the minipill. These progestin-only pills are a form of oral contraception that lacks estrogen. Though a great alternative, the minipill often results in erratic bleeding, which often triggers migraines.
Birth Control: Patch
The Patch, Ortho Evra, contains the same hormones as the pill: estrogen and progestin. But instead of coming in the form of a tablet, Ortho Evra is a beige piece of plastic that resembles a bandaid, but supplies hormones to your body. Despite functioning the same as the pill, the patch contains higher levels of estrogen, which can lead to blood clots, strokes, and can trigger migraines.
The patch works by staying on a clean piece of skin and supplying the body with hormones through the skin. The patch is known for its easy use, as it is only required to be changed once a week.
Birth Control: IUD (Intrauterine Devices)
An IUD is a tiny, t-shaped device that can be inserted into the uterus to prevent pregnancy. Best for long-term use, an IUD can last up to five years, but can be removed at any time.
There are currently five types available in the United States:
The hormonal IUD releases a small amount of progestin into the body, and works to prevent pregnancy, while also limiting menstrual-related symptoms. An IUD can cut down on cramps and make periods lighter, and maintain progesterone levels.
Like the patch, IUDs are most known for their convenience. Mirena and Liletta can last up to 7 years, Kyleena works up to 5, and Skyla works for up to 3 years.
Copper IUDs, like ParaGard, are typically not recommended for migraine sufferers. Since they work by releasing small amounts of copper into the body, they are known to potentially trigger migraines.
Warning for Birth Control and Migraine with Aura
A 2010 study suggests preventing, or limiting, the use of combination contraception, i.e. birth control that contains both estrogen and progestin. The American College of Obstetricians and Gynecologists and the World Health Organization require that women with migraine are only allowed to be prescribed combination contraceptives if they meet the following conditions:
Do not have migraine with aura
Do not smoke
Are otherwise healthy
Are over the age of 35
Migraine with aura includes the prodrome, headache, and postdrome phases that migraine without aura experiences, but those who suffer from this type of migraine note a period of visual disturbances roughly 5-60 minutes before a headache attack. Read more about the various visual disturbances here,
Combination contraceptives include a mix of estrogen and progestin, two female sex hormones that can be used to regulate period and period-related symptoms, and prevent pregnancy. A notable side effect in contraceptives that include estrogen are blood clots, or DVT (deep vein thrombosis)
Additionally, combination contraceptives, at the most extreme level, can cause strokes. But, in women with a history of migraine with aura, the chance of suffering from a stroke, or DVT, is very high. Doctors do not recommend birth control containing estrogen (progestin is safe) for women who suffer from migraine with aura, as there are safer treatment alternatives.
Like migraines themselves, the body’s symptoms and reaction to different treatment types varies depending on the person. If you are considering birth control, approach a medical professional for their opinion and guidance, as hormones differ in every woman’s body.
Remember, birth control is a temporary form of migraine relief and will not permanently maintain hormone levels. Additionally, more women report a decrease in migraine frequency and pain with long-term usage of their contraceptive. If birth control works for you and your body, this form of treatment can be relieving in not only your migraine symptoms, but menstrual-related symptoms as well.