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Is it advisable to take a 90-day BCP pill for a person with menstrual migraines and PCOS?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Uzma Arqam

Medically reviewed by

iCliniq medical review team

Published At March 27, 2023
Reviewed AtOctober 10, 2023

Patient's Query

Hi doctor,

I suffered from debilitating menstrual migraines (with aura) for years and also suffered from PCOS. About eight years ago, they became so bad that I began taking the 90-day BCP. They immediately stopped, and I have not had one since. However, I now see a GP, and she recently heard that women who have a migraine with aura should not use a BCP with estrogen. From what I have read, having migraines with auras increases the risk of stroke, and for me, the only thing that stops that from happening is the 90-day pill. My question is, is this a standard practice now, or do OBGYNs recognize the difference and can still prescribe a 90 days pill for someone like me? I also take Lipitor and Lexapro. Thank you.

Answered by Dr. Uzma Arqam

Hello,

Welcome to icliniq.com.

I thoroughly read your query and understand your concern.

Combined oral contraceptive pills (COCP) are hormones with long-term and short-term side effects and have some contraindications as well. It can result in unscheduled bleeding, irregular periods, migraine, hypertension, breast engorgement, heavy irregular inter-menstruation bleeding, endometrial hyperplasia, stroke, hypertension, cancer of the uterus and breast, etc. COCP is contraindicated in SLE (systemic lupus erythematosus), breast cancer, and migraine.

My suggestions are:

  • You can have other contraceptive methods to reduce risks of long and short-term side effects, like Medroxyprogesterone injection for three months, mini pills cyclically, Mirena intrauterine device, and implants, etc.
  • For migraine, you need to reduce the causes like tension, overwork, and stress, and you can indulge in yoga, physiotherapy, exercise, and walking daily.
  • Undergo treatment for all health issues that you have.
  • Have a healthy diet with less salt, sugar, oil, and spice.

I hope you get my point.

Best regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Uzma Arqam
Dr. Uzma Arqam

Obstetrics and Gynecology

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