Can You Take Birth Control With Migraines?

If you experience migraines and use—or are considering—birth control, it’s completely normal to wonder how one might affect the other. Can birth control help with migraines? Could it make them worse? The answer depends on the type of migraines you have, the kind of birth control you’re using, and how your body responds to hormonal shifts.

For some people, hormonal contraceptives that contain estrogen may trigger or worsen migraines. That’s because estrogen can influence how migraines show up and how often they occur. On the flip side, certain birth control methods may actually help reduce migraine symptoms for others by providing more consistent hormone levels.

The key is finding a method that supports both your reproductive health and migraine management. A healthcare professional can help guide you toward the safest and most effective option—whether that’s a progestin-only method, a non-hormonal approach, or something else tailored to your needs.

The Link Between Migraines and Your Hormones

For many migraine patients, hormones play a major role in how migraines show up. That means birth control can either help ease symptoms or, in some cases, make them worse. Understanding your body’s response is key to finding the right fit.

About 1 in 5 women experience migraines, and many notice a shift in their migraine patterns when starting or stopping hormonal contraceptives.

The hormone most often involved is estrogen. When estrogen levels rise or drop—especially just before your period—it can trigger changes in the brain that lead to migraines. That’s why many people experience their worst migraines during their period, when estrogen dips the most.

Hormone Fluctuations in Your Cycle

Birth control can help reduce these hormonal fluctuations throughout your menstrual cycle, but depending on the type and hormone dosage, it can also introduce new ones. 

Older pills had higher estrogen levels, which often led to more side effects. 

Newer low-dose options (usually between 20–35 micrograms of estrogen) are generally easier to tolerate and may be a better choice if you’re sensitive to hormonal shifts.

How Hormonal Contraceptives Can Impact Migraines

Hormonal contraceptives work by adjusting your body’s natural hormone cycle. For some, that consistency helps reduce migraines by preventing the ups and downs that often trigger them.

But for others—especially during the pill-free week—those same shifts can lead to more frequent or intense migraines.

The type of progestin (a synthetic version of progesterone) in your birth control can also influence how your body responds. Some newer formulations tend to be better tolerated by people prone to migraines.

Combined Oral Contraceptives

Combined pills—those that contain both estrogen and progestin—are effective and widely used, but they’re not always ideal for people with migraines. Estrogen can be a known trigger, particularly during the placebo (hormone-free) week when there is a sudden drop in estrogen.

Some people experience more migraines during this break, and studies have shown that migraine frequency can increase during the placebo week compared to days when active pills are taken. 

If you and your provider decide a combined pill is right for you, skipping the placebo week or choosing an extended-cycle pill might help smooth out hormone levels and reduce migraines.

Can Birth Control Cause Migraines or Make Them Worse?

Yes, in some cases. Estrogen-containing contraceptives can impact the frequency and severity of migraines, particularly for those who experience migraines with aura.

Here’s why: estrogen levels fluctuate throughout the menstrual cycle, and those shifts—especially drops in estrogen just before your period or during the placebo week—can trigger migraines. For some, starting a combined birth control pill (with estrogen and progestin) introduces hormonal changes that may increase migraine frequency.

That said, not everyone reacts the same way. Some people see improvements because hormonal birth control smooths out natural hormone fluctuations. 

Can You Take Birth Control If You Have Migraines? 

Yes—but the safest option depends on the type of migraines you have and your overall health. Many people with migraines can safely use birth control, especially methods that don’t contain estrogen.

Your provider might consider a low-dose combined pill or recommend skipping the placebo week to avoid hormone withdrawal headaches.

If you have migraines with aura or other stroke risk factors, a progestin-only or non-hormonal method may be a better fit. Some migraine-friendly options include:

• Slynd®: a progestin-only pill with a flexible dosing window
• Mirena®: a hormonal IUD that releases a low, steady dose of progestin
• Depo-Provera®: a progestin injection every 3 months
• Paragard®: a hormone-free copper IUD

These options avoid estrogen and tend to be well tolerated by people prone to migraines.

Tips For Managing Birth Control and Migraines

If you’re navigating both birth control and migraines, a few strategies can help:

• Track your migraines before and after starting a new method
• Skip the placebo week if you’re using a combined pill (ask your provider first)
• Avoid estrogen-based methods if you smoke or have other risk factors
• Check for interactions with migraine prevention medications

What to Consider When Choosing Birth Control

When it comes to finding the right birth control, migraines are just one part of the picture. Your overall health, lifestyle, and any underlying risk factors all play a role, and it’s important to consider the full context to make a safe and informed choice.

Know Your Risk Factors

Some health and lifestyle factors can increase the risks associated with hormonal contraceptives, especially those that contain estrogen. 

For example, smoking significantly raises your risk of cardiovascular issues. If you’re over 35 and smoke, estrogen-based birth control isn’t recommended, regardless of your migraine history.

Other conditions that need careful consideration include:

• High blood pressure
• Diabetes
• A history of blood clots or stroke
• A strong family history of cardiovascular disease

If any of these apply to you, your healthcare provider can help you explore safer alternatives that still meet your needs.

Medications Matter, Too

Some migraine prevention medications—especially anti-seizure drugs—can reduce the effectiveness of hormonal contraception. On the flip side, certain contraceptives may also impact how well your migraine medications work.

This is why it’s so important to share your full medication list with your provider when discussing birth control options.

What About Menopause and Hormone Replacement Therapy? 

If you’re navigating perimenopause or menopause and also experience migraines, hormone replacement therapy (HRT) may offer relief, but it’s important to approach it thoughtfully. Just like with birth control, hormonal shifts can influence migraine patterns. Some people notice their migraines improve after menopause, while others find that the transition makes things more unpredictable.

HRT can help smooth out these fluctuations, but the way it’s delivered and the type of hormones used can make a big difference, especially if you’re prone to migraines.

What to Know About HRT and Migraine Management

• Transdermal estrogen (like patches or gels) may be a safer option than oral estrogen for people with migraines. These methods release hormones steadily through the skin, avoiding the spike in liver activity (called “first-pass metabolism”) that comes with pills—and that can affect blood clotting and migraine patterns.
• Lower, consistent doses are typically better tolerated by migraine sufferers than high or fluctuating hormone levels.
• If you have migraine with aura, it’s especially important to talk through your options with a healthcare provider. This type of migraine is linked to a higher risk of stroke, and certain types of HRT may increase that risk.

Finding the right hormonal balance during this stage of life can take some trial and error, but you don’t have to figure it out alone. A healthcare provider who understands both menopause and migraine can help guide you toward an approach that supports your overall well-being.

Making Informed Choices About Birth Control With Migraines

Choosing birth control when you have migraines can feel like a balancing act, but understanding how different options interact with your migraine patterns helps you take control of both your reproductive and neurological health.

The most important thing to remember is that there’s no one-size-fits-all solution. What works well for one person might not work for another, and that’s okay. If you have migraines with aura, starting with safer options like progestin-only methods or non-hormonal alternatives is usually the best approach.

Finding the right fit may take some trial and error, and it’s completely normal to adjust your plan along the way. That’s why it’s so helpful to work with a provider who understands both birth control and migraines—someone who will listen to your concerns and review your full health picture.

Whether you choose a hormonal IUD, a copper IUD, progestin-only pills, or another method, the right birth control is one that effectively prevents pregnancy without making your migraines worse.

Ready to find the right pill for you? Start your birth control consultation with Nurx today—it’s simple, affordable, and delivered straight to your door.

Frequently Asked Questions (FAQ):

Which birth control is best for migraine sufferers?

Progestin-only methods, like the mini-pill, hormonal IUDs, or the Depo shot, are generally preferred, especially for those with migraines with aura. These options don’t contain estrogen, which is linked to an increased risk of stroke.

Can you be on birth control if you have migraines?

Yes. Many people with migraines can safely use birth control, but the type matters. Your provider can help you choose a method that fits your needs while minimizing risks.

Why can’t I take estrogen birth control with migraines?

Estrogen-containing birth control (like the pill, patch, or ring) can increase the risk of stroke in people with migraines with aura. That’s why progestin-only or non-hormonal options are often recommended instead.

Can you use a vaginal ring if you have migraines?

The ring contains estrogen, so it may not be the best choice if you experience migraines with aura. Always talk to a provider before starting or switching methods.

The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional.

Slynd® (drospirenone tablets 4mg), Rx only, is used to as contraception to prevent pregnancy. Slynd® may cause side effects, the most common is irregular bleeding. Other less common side effects may include headache, breast pain and tenderness, weight gain, menstrual cramps, nausea, severe vaginal bleeding, less sexual desire. If you would like to learn more about Slynd®, please see the full prescription information, here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH or call 1-800-FDA-1088.

Norethindrone (progestin-only tablets, USP .35mg), Rx only, is an oral contraceptive used to prevent pregnancy. Norethindrone may cause side effects, including nausea, headache, breast tenderness, irregular bleeding, and missed period. If you would like to learn more about norethindrone, please see the full prescription information here. You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.