Scientists are not certain why, but people who experience migraines with aura are about 2-4 times more likely to experience a stroke when they take oral contraception that contains estrogen.
Migraines are common in women of reproductive age, and 3x more common in women than in men overall. This is, in part, due to the existence of menstrual migraines, which half of female migraine sufferers experience. These are migraines brought on by a dip in estrogen, the same hormonal lapse that triggers menstruation. Birth control can potentially worsen menstrual migraines by supplying the body with synthetic estrogen and then withdrawing this supply during the placebo week. However, extended use birth control can potentially help women manage their menstrual migraines by continuing this estrogen supply for months on end, preventing migraine-triggering periods.
About a quarter of all migraines are accompanied by aura, a kind of visual or sensory disturbance. For most people, aura looks like blind spots, flashing lights, or zigzag patterns, but it can also cause temporary blindness, hallucinations, paresthesia (a burning or prickling sensation), and aphasia (the inability to speak). If you experience migraines with aura, your doctor will likely recommend a birth control method that is low in estrogen, such as the patch, ring, or progestin-only minipill. There are several low-dose estrogen formulations of the combination pill that might work for you as well. Birth control can help or hurt your migraines, depending on whether or not you experience aura, and what kind of birth control you use. It’s important to talk to your doctor about your migraines so you can experiment safely and find the best contraceptive method for you.
The Simple Health team is passionate about all things health. Follow along—we're just getting started.