The exact cause of migraine is not known. In the United States, around 12% of people have migraine. These may include nausea, weakness, and sensitivity to light, sound, or smell. In most people, migraine causes multiple symptoms. Migraine headaches are different from other types of headaches. It is a neurological condition, meaning it starts in the brain. Migraine is a debilitating disorder that causes severe headaches. For example, the progestogen-only pill (POP), the progestogen injection, intrauterine contraceptive devices (IUCDs) or the intrauterine system (IUS), and barrier methods are usually suitable.Share on Pinterest AnnaStills/Getty Images As above, there are a number of other methods of contraception available for women with migraine who should not take the pill or use the patch. This means having a good method of contraception is very important for women who are on these medications. It is essential that you use really effective contraception, such as the contraceptive injection, an intrauterine coil or IUS, or a combination of the COC pill along with a barrier method of contraception.Topiramate can make hormonal contraception less effective.If you are taking topiramate when you are pregnant, there is a risk of birth defects in your baby.Topiramate (another medicine usually used to treat epilepsy) can be effective in reducing the frequency and severity of migraines.Sodium valproate (a medicine usually used to treat epilepsy) should not be used as a preventive treatment for migraine for any women who might get pregnant.The National Institute for Health and Care Excellence (NICE) has updated its guidance on headaches, to include extra warnings about the use of some preventive medication for migraine - see 'Further Reading' below. If you have frequent or very severe migraines, you may be advised to take treatment every day to prevent migraines. For example, the progestogen-only pill (POP), the progestogen injection, intrauterine contraceptive devices (IUCDs) or the intrauterine system (IUS), and barrier methods are usually suitable.Ĭontraception for women who take preventive medication for migraine There are a number of other methods of contraception available for women with migraine who should not take the pill or use the patch. This means that the only women with migraine who can take combined hormonal contraceptives are women who are aged under 35, and who had already experienced migraine attacks without aura before they started taking the pill or using the patch. If you did not previously have migraine, and then migraine attacks first developed once you started taking the pill or using the patch.If you already have migraine headaches without aura and are aged 35 or above.If you have a past history of having migraine attacks with aura either on, or off, the COC pill.If you already have migraine attacks (episodes) with aura.In general, you should not take combined hormonal contraceptives: Doctors therefore advise against using combined hormonal contraception if you experience migraine with aura, as this is puts you at a small but unnecessarily increased risk of something very serious. This is still a very low risk, but it is an increased risk of something very serious (having a stroke). The combination of taking combined hormonal contraception plus having migraine with aura increases the stroke risk by a little more than this, multiplying it by 2 to 4.The combination of taking combined hormonal contraception plus having migraine without aura increases the risk of stroke slightly more than either alone.If you take oestrogen and you have migraine the risks increase a little more, because now two risks are present. The increased risk of having a stroke is slightly higher in people who have migraine with aura. If you have migraine without aura, you have a slightly increased risk of having a stroke compared with the normal risk. Taking oestrogen causes you to have a slightly increased risk of having a stroke (compared with the normal risk). They are generally used for 21 consecutive days, followed by a 7-day break (in which you may have a period). They are all called 'combined hormonal contraceptives'. The combined oral contraceptive (COC) pill ('the pill'), the contraceptive vaginal ring ('the ring') and the contraceptive patch ('the patch') contain the chemical (hormone) oestrogen. Why are women with migraine who take the pill or use the vaginal ring or the patch a special case?
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