Migraines And Birth Control

Migraines and Birth Control: What You Need to Know

Migraines and birth control can affect each other in different ways. This depends on the type of migraine you have and the type of contraception you use.

Here is a simpler way to understand it:

• People who have migraine without aura may find that some hormonal birth control helps their headaches. This is because it keeps hormone levels more stable.
• People who have migraine with aura are usually advised not to use birth control that contains oestrogen. This is because it can increase the risk of stroke. Safer options are available for them.
• If your migraines get worse after starting birth control, or if you notice new symptoms like vision changes or numbness, you should speak to a doctor.
• If headaches mostly happen during the days when you stop taking active pills, this may be caused by a drop in hormones. Changing the type of birth control can often help.

Choosing the right birth control is different for everyone. It should be based on:

• The type of migraine you have
• Your general health
• Your personal risk factors

A healthcare professional can help you decide what is safest and best for you.

Migraine With Aura vs Without Aura and Why It Matters

Not all migraines are the same. Knowing which type you have is important when choosing the right birth control. The two main types are migraine without aura and migraine with aura. Each type affects which contraception is safe to use.

Migraine Without Aura

This is the most common type of migraine.

It usually causes:

• Strong head pain, often on one side
• Feeling sick (nausea)
• Sensitivity to light or sound
  
  

There are no warning signs before the headache starts.

Many people notice their migraines happen around their period. This is called menstrual migraine. It happens because hormone levels change during the month.

Some hormonal birth control methods can help by keeping hormone levels more stable. For people with migraine without aura and no other health risks, certain hormonal contraception options may be suitable after a medical check.

Migraine With Aura

Migraine with aura includes extra symptoms that happen before or during the headache. These symptoms usually last between 5 and 60 minutes and can happen with or without head pain.

Common aura symptoms include:

• Seeing flashing lights, zigzag lines, or dark spots
• Tingling or numbness in the face, arm, or hand
• Trouble speaking or finding the right words
• Feeling dizzy or off balance

Migraine with aura is important to identify because using birth control that contains oestrogen can increase the risk of stroke.

Because of this, combined hormonal methods like the combined pill, patch, and ring are usually avoided in people with migraine with aura.

Safer options include:

• Progestogen-only contraception
• Non-hormonal contraception

These do not carry the same risk linked to oestrogen. Choosing the right birth control should always be based on your migraine type, your health, and advice from a healthcare professional.

How Hormones and Oestrogen Trigger Migraines

Hormones play a big part in migraines for many people. This is especially true when migraines happen around the time of a period. The main hormone involved is oestrogen, which fluctuates throughout the month.

In a normal menstrual cycle, oestrogen levels rise before ovulation and then drop quickly just before a period starts. This sudden drop can trigger a migraine. That is why many people get migraines just before or during their period. These are often called menstrual migraines.

Hormonal birth control changes how hormones work in the body. Some types keep oestrogen levels steadier throughout the month. This can reduce the hormone drop that causes migraines, so some people notice their headaches improve after starting birth control.

However, everyone reacts differently. Some people are very sensitive to hormone changes. When they first start birth control, the new hormones can make migraines worse for a short time, usually during the first two or three months.

Migraines can also happen during the break days of a pill pack. This is because oestrogen levels fall again when hormone therapy is stopped.

Whether birth control helps or worsens migraines depends on:

• How stable are the hormone levels are
• How sensitive the person is to hormone changes

This explains why migraines get better for some people and worse for others after starting contraception.

Can Hormonal Birth Control Reduce Migraines?

For some people, birth control can help reduce how often migraines happen and how painful they are. This is most helpful when migraines are linked to the menstrual cycle.

This happens because some birth control methods keep hormone levels steadier during the month. This can stop the sudden drop in oestrogen that often triggers migraines.

Birth control may help people who:

• Get migraines just before or during their period
• Have migraine without aura
• Notice their headaches get worse when hormones change
• Like having a regular and predictable cycle

Some types of hormonal birth control work better for migraine control:

• Monophasic pills, which have the same hormone dose every day
• Continuous or extended use methods, where the inactive pills are skipped or reduced

These methods can help prevent headaches caused by hormone drops.

However, birth control does not help everyone.

• Some people get fewer migraines.
• Some notice no change.
• Some may have more headaches at first, especially in the first few months.

Keeping track of headaches over time can help show whether a method is helping.

Choosing birth control for migraines should be based on:

• The type of migraine you have
• Your overall health
• Advice from a healthcare professional

It should not be chosen only to control migraines.

When Birth Control May Worsen Migraines

Some people find that their migraines get worse after starting birth control. Headaches may happen more often or feel more painful. This is most common in the first two or three months as the body adjusts to new hormone levels.

Migraines can worsen because:

• The body is sensitive to the hormones in birth control
• Hormone levels drop during the inactive or pill-free days
• Even small hormone changes can trigger migraines
• The type of birth control is not suitable for that person’s migraine type

Some people feel fine for most of the month but get migraines during the inactive pill days. This happens because oestrogen levels fall during these days, which can trigger headaches, just like before a period.

A more serious warning sign is getting new symptoms after starting birth control, such as:

• Seeing flashing lights or blurred vision
• Numbness or tingling
• Trouble speaking

These may be signs of migraine with aura and should be checked by a doctor. Until this is assessed, birth control that contains oestrogen should be avoided.

If migraines do not improve after the first few months, or if they become much worse, a different type of contraception or a different schedule may be needed. A healthcare professional can help decide what is safest and best.

Safe Birth Control Options by Migraine Type

The best type of birth control depends on whether your migraines happen with aura or without aura, and if you get any new warning symptoms after starting contraception.

Some birth control methods are safer than others because of how they affect hormones and stroke risk.

Combined hormonal contraception includes:

• The combined pill
• The patch
• The vaginal ring

These contain oestrogen and progestogen and are usually not advised for people who have migraine with aura.

Progestogen-only and non-hormonal methods do not contain oestrogen and are often safer choices.

Contraception Options by Migraine Type (Simple Guide)

 

Migraine type	Combined hormonal methods (pill, patch, ring)	Progestogen-only options	Non-hormonal options
Migraine without aura	May be suitable after a medical check if there are no other risks	Often suitable	Often suitable
Migraine with aura	Usually avoided because of higher stroke risk	Often suitable	Often suitable
New aura symptoms after starting combined contraception	Stop and get medical advice	Consider changing the method	Consider changing the method

Other health factors can also affect which birth control is safest, such as:

• Smoking
• High blood pressure
• Heart or blood vessel problems in you or your family

A healthcare professional can assess these risks and recommend the safest option.

There are many good choices for people who cannot use birth control with oestrogen. Changing to a different method often helps improve migraines and makes side effects easier to manage.

Why Migraines Happen During Pill Free Days

Some people notice that their migraines mostly happen during the inactive or hormone-free days of their birth control pack. This is often caused by a sudden drop in oestrogen, which is similar to what happens just before a natural period. These are sometimes called hormone withdrawal migraines.

Keeping track of when your migraines happen can be very helpful. A simple headache diary can record:

• The day the migraine starts
• How bad it feels
• Any other symptoms

This can help a healthcare professional decide if your birth control needs to be changed.

Migraine Patterns and What They May Mean

When migraines happen	Possible cause	What to discuss with a clinician
Mostly during inactive pill days	Hormone drop (withdrawal)	Shorter pill-free break or using pills continuously
Soon after starting a new method	Body adjusting to hormones	Review after a trial period or think about changing the method
New symptoms like vision changes or trouble speaking	Possible migraine with aura or another cause	Get urgent medical advice and avoid oestrogen until checked

For some people, using birth control continuously or having fewer hormone-free days can help stop these migraines.

Others may feel better by switching to:

• Progestogen-only contraception
• Non-hormonal contraception

These avoid changes in oestrogen levels altogether.

Any new or changing migraine pattern should be checked by a healthcare professional. This helps make sure the symptoms are not caused by another health problem or by a birth control method that is not right for you.

Migraine Warning Signs That Need Urgent Review

If your migraines change after starting birth control, this should not be ignored, especially if the changes are sudden or involve new symptoms. Some signs need to be checked by a healthcare professional as soon as possible to make sure the birth control you are using is safe.

Red Flags That Need Prompt Review

Symptom	Why is it important
First migraine with aura or a change in aura symptoms	This can increase health risks when using birth control that contains oestrogen
Weakness, numbness, or trouble speaking	These may be signs of a problem with the brain or nerves, and need checking
A sudden, very severe headache that feels different from usual	This could point to a serious medical condition

If any of these symptoms happen after starting a new birth control method, the birth control that contains oestrogen should be stopped until a healthcare professional has reviewed the situation.

Getting medical advice quickly helps:

• Keep you safe
• Choose the right type of contraception
• Reduce the risk of serious problems
• Avoid unnecessary pain and worry

Always seek medical help if your migraine pattern changes or new symptoms appear.

Online Medical Advice for Migraines and Birth Control

Mobi Doctor can help people who experience migraines and have concerns about birth control through a professional Online Consultation with a qualified clinician. A clinician can review your symptoms, identify your migraine type, and explain which contraception options may be suitable for you based on your medical history. They can also give guidance if your migraines have changed since starting birth control and advise when a different method may be safer or more effective. This support helps you make informed choices and manage your migraines with confidence and guidance from a qualified medical professional.