Does estrogen in birth control trigger migraines?

Question

Hi doctor,

I have been having migraines for years, but they have become much worse since I started using hormonal birth control. I am 28, and I take combined oral contraceptives, but now my migraines often come right before my period. I read about menstrual migraines and how estrogen plays a role.

Should I switch birth control methods?
I also worry about taking migraine medications if I get pregnant. Are there safer options for women planning to conceive soon?

I feel stuck between managing migraines and planning my reproductive health.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Yes, hormones do play a role, especially during the perimenstrual period, which occurs before your period starts. Sometimes, this may be part of a condition called premenstrual syndrome (PMS).

The signs and symptoms of PMS may include mood swings, tender breasts, food cravings, fatigue, irritability, and depression. It is estimated that as many as three out of every four menstruating women experience some form of PMS.

Management: First, avoid foods that trigger migraines. Common triggers include:

Chocolate: Contains tyramine, which can constrict blood vessels and trigger migraines.
Aged cheese: Also high in tyramine.
Alcohol: Red wine and beer are especially likely to trigger attacks due to their high histamine content.
Caffeine: Both excessive intake and sudden withdrawal can lead to migraines.
Processed meats: These often contain nitrates and nitrites, which can cause blood vessel swelling.
MSG (monosodium glutamate): A common food additive that can trigger migraines in some individuals.
Artificial sweeteners: Aspartame is a known trigger for some people.
Nuts: Some individuals find nuts to be migraine triggers, possibly due to their histamine content.

You should consult a neurologist for further evaluation and treatment planning. If you are planning for pregnancy, start taking folic acid 5 mg once daily (0+0+1), at least three months before trying to conceive.

It is also important to consult a gynecologist to review any medications you are currently taking for migraines. Do not worry. Your migraines can be managed safely during pregnancy with proper care.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.