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What is a migraine with aura?

Dr. Charisse Litchman

Medically reviewed by Dr. Charisse Litchman, MD, FAHS on August 18, 2020

A migraine with aura is a migraine that is preceded or accompanied by  sensory disturbances which may include:

  • Visual disturbances like seeing sparks or zig-zag lines in your field of vision.
  • Tingling on one side of the body
  • Difficulties with speech or language
  • Difficulty controlling movement

To meet the clinical definition of “migraine with aura” the symptoms must meet at least three of these requirements:

  • At least one aura symptom starts gradually over a span of 5 minutes or longer
  • Two or more of the aura symptoms occur in succession
  • Each individual aura symptom lasts between 5 minutes and an hour
  • At least one aura symptom occurs on one side of the body  
  • At least one aura symptom is a sensation (like seeing flashing lights or feeling tingling) 
  • The aura is accompanied by or followed within 60 minutes by a headache

Birth Control and Migraine with Aura

It is recommended that women who experience aura with their migraines do not take birth control containing estrogen because it would put them at greater risk of stroke, heart disease, or blood clot. This includes combination birth control pills, the birth control ring, and the birth control shot.

The risk of estrogen to women with migraine with aura is even higher in women who smoke, who have a history of previous blood clots or a family history of blood clots, and possibly in some women who have had previous miscarriages. 

Instead, Nurx will prescribe women who experience aura progestin-only pills or the birth control shot, which contains only progestin. Two other options are a hormonal IUD or a birth control implant, which you can access from an in-person doctor. Progestin-only contraception is safe for women experiencing migraine with aura.

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