Special Considerations for Migraine Sufferers

Unlike the average woman, women who experience migraine headaches should think twice about using oral contraceptives during perimenopause. It has been suggested that a history of migraines can increase a woman’s risk of having a stroke. However, this seems to be limited to women who have an aura before their migraines or who have other neurological symptoms. For this reason, if a woman is considering starting birth control pills for the alleviation of perimenopausal symptoms and is also experiencing migraines, she should be sure to see a neurologist first. He/she will be able to tell whether or not it would be okay to start on the pills.

For women who have migraine headaches that are not associated with neurologic symptoms, a low-dose oral contraceptive can probably be used, but consulting a doctor would be a good idea. Use of the pills should be ended if the headaches get any worse or if they start occurring more frequently.

Who is Not Eligible

The contraindications listed for use of oral contraceptives in women past age 35 are:

• Smoking
• Hypertension
• History of thromboembolism (a condition that involves blood vessel clots)
• Stroke
• Estrogen-dependant abnormal tissue growth (tumor or cancer)
• Undiagnosed atypical genital bleeding (vaginal bleeding)
• Cholestatic jaundice (jaundice that is caused by blockage of the outlet of the gallbladder)

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