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What should I do if I develop headaches or migraines from my birth control?

Jenny Ingle Pappas

Medically reviewed by Jenny Ingle Pappas, MSN, APRN, FNP-C on September 17, 2020

Headaches and migraines can be pesky things to pin down — sometimes you know what brought one on, other times they can be triggered by who-knows-what. The changes that come along with starting a new form of birth control can sometimes aggravate headaches, making them more severe or more common than you’re used to.

Birth control affects every woman uniquely, and its potential impact on headaches is no different. If you’re worried that your birth control may be making your headaches or migraines worse, there are a few things you need to know first:

Headaches & Hormones

Hormonal birth control contains either estrogen and progestin, or progestin alone. These hormones regulate menstrual cycles, and they can also have an impact on hormonal headaches. 

Fluctuations in levels of estrogen have been found to cause headaches in some women. Estrogen dips naturally in the body before a period begins, so many women find that this time is associated with higher levels of headache activity. Because combination birth control steadies out hormone levels and causes a less severe drop in estrogen before menstruation, many women find that birth control makes headaches better.

Headaches on Birth Control

For some women, headaches are a birth control side effect, especially at first. The estrogen in combination birth control can cause a sudden flurry in headache or migraine activity, but they tend to subside as your body gets used to the increased overall hormone levels. While you should try to be patient, headaches that persist past 3 months are a sign you should ask your doctor for an adjustment to your prescription. A birth control option with less estrogen or no estrogen at all may be a better choice. For those looking to avoid estrogen-based birth control methods entirely, there are a few options available such as the minipill or the Depo-SubQ Provera shot. These progestin-only options can protect you from unwanted pregnancy without interfering with your body’s natural levels of estrogen.

Most combination birth control pills have a set number of “placebo days,” meaning that you don’t take any hormone-containing pills for a certain amount of time every month, and you have a period. If the drop in estrogen during these “off” periods still brings on headaches, you may be able to solve this by switching to a birth control pill option you can take continuously, ensuring that your hormone levels stay as constant as possible. 

If you’re not sure what exactly about your birth control seems to be causing headaches, talk to a medical professional to see what your options are. There are dozens of different birth control brands, all of which contain different levels of estrogen and progestin — experimenting with several different options can help you pinpoint exactly which is right for you.

Migraines on Birth Control

When it comes to birth control, migraines have much in common with normal headaches: they can be agitated by fluctuations in estrogen levels and often return to previous frequencies after a few months of usage. 

With that being said, migraines with aura are different beasts entirely. An aura is a warning symptom or set of symptoms that occur prior to the migraine, such as:

  • the perception of a bright light
  • zig zag lines in your vision
  • partial or total loss of vision
  • blurry or obscured vision
  • numbness or tingling in part of your body
  • partial or full paralysis
  • perception of an unpleasant smell
  • dizziness or vertigo
  • upset stomach or nausea
  • confusing thoughts, experiences, or visual phenomena

Women who experience migraines with aura should not be taking hormonal birth control containing both estrogen and progestin, as the estrogen can heighten the risk of stroke. If you experience any of the above symptoms while taking combination birth control, stop taking it and talk to your healthcare provider about switching to one of the progestin-only methods listed above.

Treatment Options

Many women may find that birth control is in fact its own treatment for headaches: keeping hormone levels constant, headache activity is reduced to a minimum. For those who experience more headaches or migraines while on birth control, there is hope: a number of different treatment options are available that can help suppress headaches without forcing you off of your birth control method. 

Finding the right birth control method for you can be an overwhelming process. With the vast number of options out there for you to choose from, it can feel impossible to know what the best one is. Get started by providing your medical history to get customized recommendations from our experts.

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