Oral Contraceptives
and Migraine

Some types of the  oral contraceptive pill (The Pill) also have an increased risk of stroke. For this reason it very important to speak with your GP about the best options for you and your condition.   

Headaches are a common side effect of taking oral contraceptives and in most cases usually improve over time. They can be affected by the dose and type of hormone in the pill. Some women find that their headaches and migraines improve when they start the pill; others notice that their headache and migraine gets worse. It is important to find the pill that suits you best in consultation with your doctor and if you’re worried about your headaches or migraines please make an appointment with your GP.  

If you suffer from migraine with aura you should not take the Combined Oral Contraceptive (COC) pill. This is because the combined pill is associated with a very small increased risk of ischaemic stroke. The risk is extremely small but should be avoided.  
The COC pill is not contraindicated in women who have migraine unless they are affected by migraine with aura. The effects of COC use are quite variable:  
  

• Migraine may improve
• No change in frequency or severity
• Migraine may become more frequent or more severe
• New onset of migraine (particularly if there is a family history)
• Change from Migraine without Aura to Migraine with Aura
• Migraine may occur in the pill-free interval only

If the patterns of migraine change for the worse or if the patient experiences aura for the first time, the oral contraceptive should be discontinued. After discontinuation, about 30-40% of this group will improve but this improvement may not occur for up to one year.  
  
For more information about using oestrogen supplements speak to your doctor