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

Question

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.

Answer 1

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.