I recently started using birth control pills and also have migraines with aura. I was first prescribed Sprintec (generic Ortho-Tri-Cyclen) which was okay until my off-week and I had an absolutely debilitating migraine. I tried to get an IUD placed, but was told that my uterus was waaay too small (doctor said the IUD was bigger than my uterus!) I was switched to Lo-LoeEstrin, which I could only tolerate for maybe a week, because I was having daily migraines.

I was put on Micronor, and am on my fourth month on it. My bleeding has stopped being so irregular, but I get much longer and heavier periods than I ever did before taking the pill. I also am still getting migraines, and I also get these sort of “low-level migraines” where it feels like a small migraine for several days.

So any suggestions on what to do next? The IUD seemed absolutely perfect, I was really bummed I couldn’t get it. Are the other brands of POPs worth trying?

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25 Responses to Migraine with aura and BC

  1. EsiSmall says:

    It’s recommended that you don’t use HBC if you have migraines with aura. It can increase the risk of stroking out, among other things. Trust me when I say that having one side of your body go totally numb is not fun.

  2. SdrNobody says:

    Why do doctors prescribe it to me then? And what other forms of BC can I use then, or is it just condoms?

  3. EsiSmall says:

    I have no idea, but that’s what I was told. They asked me if I had migraines with aura before putting me on HBC. I said no, because my migraines have always presented without aura, and I ended up having a ministroke/TIA anyway.

    I’m not saying that will definitely happen to you, but it did happen to me, so it’s something to be aware of. POP pills are supposed to be safer for women who have migraines with aura, but if you’re still having migraines on them, I would look for something else. I had migraines every day I was on HBC until I had the ministroke.

    I’m not sure what I could suggest to you instead. Hopefully someone else will have a better idea. Best of luck.

  4. Nedoeva says:

    They tried me on nuvaring because that is more localized and less systemic and I didn’t have migraines with that.

    I’m surprised they are prescribing it to you because they made me go off HBC pills because of my migraines.

    Condoms, diaphragms, and non-hormonal IUDs are the choices I’m aware of that are not permanent options. FAM is another option depending on your circumstances.

  5. SdrNobody says:

    I had to ask for POPs because they kept prescribing me pills with estrogen in them which was absolutely horrible. Everyone else who seems to take POPs has great results: short to no period, acne clears up, headaches lessen. Not me!

  6. Nedoeva says:

    I can’t take POPs either. I tried them briefly after my daughter was born. My husband had a vasectomy so that I didn’t need to worry about birth control.

  7. OtiGirl says:

    Chiming in to say “me too” with the POP thing. I tried them in high school for my bad cramping. I made it three days before I gave up because the migraines were constant and probably the worst I’ve ever had.

    Nuvaring didn’t give me migraines from what I remember, but I stopped taking it because my depression was getting worse.

  8. Nedoeva says:

    Hrm. Interesting. That’s what the doctor told me at the time. I could use it and stack it without problems at first, then when I had to remove it I had migraines so I gave up on that one too.

  9. EohNet says:

    Yeah, I don’t know why doctors don’t read the prescribing information.

  10. SseNope says:

    I think it partially depends on the reason for your migraines: If they’re caused by PMS, then HBC sometimes can prevent said migraines, and so the risk is lowered? I’m not sure why, though! I’m going off of what PP told me back in 2007.

    Another progesterone-only method to consider is Implanon/Nexplanon/Norplant. The dosage is higher than the Mirena, but significantly lower than Depo. Plus, no super time-sensitive delivery!

  11. SseNope says:

    Also, the stroke risk seems to be limited to the estrogen, not all hormones. This study says: There is general consensus that progesterone-only contraceptives are safe for use in women who have migraine with aura, even in the presence of other risk factors for stroke.

    So progesterone-only methods are fine. According to the above meta-study, it’s not 100% clear that estrogen is always bad. What’s more evident is that progesterone is okay.

    Another thought: Is your doctor generally pro-IUD? Every so often on cf_resources, we get a poster whose doc declares their uterus unable to have an IUD, only to discover later that the doc was actually biased against nulliparous uterus-owners having one. (When their partner gets a vasectomy, they’re suddenly okay with it, the doc also rejects other attempts at long-term birth control, or otherwise makes clear his stance.)

  12. SseNope says:

    Yet ANOTHER thought (god, sometimes I wish I had comment editing): How old are you? Teenagers tend to have smaller uteri than older people, so if you’re under 25, it’s possible that your uterus might grow.

    That said, I don’t know the stats on that. This study basically says that by pubescent stage 3 of 5, most uteri are 5-7 cm, but the one stage 4 uterus was an outlier. Figure 3 in this study shows that even the 18 yos did not have uteri as large as the adult controls. I don’t know if this is statistically significant, but I think it gives younger people hope!

    If your uterus has a structural abnormality (like being bicornuate, or having a septum), it could appear smaller to the sound than it is in actuality. But that would also make it ineligible to bear an IUD. Having a retroverted uterus can make it more difficult to measure (and the IUD more difficult to insert), but does not affect its functional size.

  13. SdrNobody says:

    I’m 28, so I’m guessing it’s going to grow as much as it can. The doctor who originally was going to do it was super pro-IUD, she thought it was fantastic. Due to an epic screw up at their office, I tried to get it inserted at a different office with a doctor I didn’t know at all. But he did the sounding and just said that my uterus was super tiny, that the IUD itself was wider and taller than my uterus (he showed me the little model of the uterus and said mine was half that). I don’t know if it’s worth a second opinion (and I’d have to go to yet another doctor because I lost my health insurance).

  14. SdrNobody says:

    And I was a member of iud_divas and everything! Here is my tale of what might have been.

  15. SseNope says:

    Aw, damn!

    If you do decide to give it another go, I highly recommend PP or another birth control/reproductive health clinic, like those run by the county. People there often literally do them every week or more.

  16. Kdgle says:

    Yeah, I don’t know why docs prescribe HBC, and estrogen-containing pills in particular, to folks with migraines with aura. I had the same experience — I get migraines with aura, and I was on oral contraceptives for five years! I finally went off of them when I realized that my migraines were getting worse over time. My headaches went away (for the most part) once I got off of them.

    I have super-duper heavy periods, and we needed to find something to help me cope with the crazy bleeding. Despite the fact that I’ve never had kids (nor been pregnant) the Mirena IUD is working great for me. It has a very low dose of progestin in it, but it hasn’t seemed to trigger migraines and I’m reasonably sure it’s not affecting my mood, either.

    Did your doc measure your uterus (through sounding)? Sometimes docs are very reluctant to give nulliparous women IUDs even though there is plenty of evidence that folks do just fine with them. [Edit to clarify: If your doc measured your uterus and the IUD won’t fit, then it won’t fit. If they didn’t measure and based their assertions on your pregnancy history, then they might be wrong and it might fit fine.]

    If you are not allergic to spermicide (like me, ugh) you can also check out diaphragms and cervical caps as birth control options. My mum used a diaphragm for 25 years and had zero unplanned pregnancies! To me, that’s a pretty strong recommendation. 🙂

  17. SdrNobody says:

    Yeah, they did the sounding and he said I was way too small and he though it would definitely perforate if it went in.

  18. Kdgle says:

    Oh dear, I’m sorry. Sounding sucks in terms of being painful, so yeah. I’m sorry that you had that happen and then couldn’t get an IUD!

    Because I’m allergic to spermicide AND latex (fun times) my pre-IUD partners and I used a combination of FAM and non-latex condoms. I am super-regular, so it was easy for me to track my ovulation and use condoms when we needed to prevent pregnancy. At others times, we didn’t use them. I had only one misstep, and it was because we had a condom malfunction – during – my fertile period. I took Plan B just to be sure as I knew there was a likelihood I could get pregnant at that time of the month.

    I think quite highly of FAM because it was free and because it helped me get way more comfortable with my body and what it was up to. Might be worth giving a try together with condoms as you figure out what you would like to do?

  19. SdrNobody says:

    Yeah, the sounding hurt a lot. What was worse is that he started talking to me about how he couldn’t insert it while the clamp was still on my cervix. Yow!

    Condoms irritate my nethers intensely. I could probably try some other brands, but ugh, I’m so turned off on them after the times I tried. I really wanted something more secure than FAM (and something I wouldn’t have to constantly work on), but who knows.

  20. Kdgle says:

    Condoms gave me horrifically burn-y vaginal tissues until I started using non-latex ones. (I also think the latex ones smell horrible and just the smell makes me faintly queasy.) I like the Trojan Supras and the Durex Bares, with silicone lube when we need it. It seems that some of my partners find one brand a better fit, whilst others prefer the second brand. I’m sure you’ll hear more from others…I really, really sympathize with you.

  21. Hteall says:

    You might want to try lambskin condoms (Naturalamb brand in the US) — though they are expensive, they are definitely the anti-vegan, they do not protect vs. STDs, and while I think they smell nice (kinda like apples?), I’ve heard a couple of other people who don’t like the odor at all. But in my experience, they feel at least as good and sometimes better than bare.

    Good luck!

  22. EohNet says:

    As far as I know, there’s only one formulation of POP in the US. The different brands use the same dosage of the same progestin. It’s possible you’d have better luck with Implanon or Depo Provera, if you are still interested in hormonal methods, but those are more of a commitment and you could have the same problems.

  23. SdrNobody says:

    Yeah, I was just researching and found that out. I’m nervous about implanon and depo because if my symptoms are even worse, then I’m stuck with them for a lot longer.

  24. EohNet says:

    Well, they can take the Implanon out, but it would be a hassle. I totally understand your reluctance–I’d be the same way.

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