I have been on birth control pills for several years.  I have been
taking my current pill "yasmin" for about 9 months, and have been
getting increasingly frequent migraines ( I had never before had this
problem).  I have read that many women experience this side effect
from this particular pill as well as several others. While I know each
woman's body reacts differently to the pill, is there an oral
contraception with a dosage/chemical compound recommended for
potential migraine sufferers?

Any advice would be appreciated.
Thank You!

Hi bambs,

Have you noticed a correlation between the timing of your headaches
and the timing of the first day of your period? Some studies suggest
that since estrogen levels are similar in women who get headaches, and
women who don?t, the drop in estrogen during the first day of
menstruation may be the trigger for migraines in women on oral
contraceptives. Known migraine trigger foods, such as chocolate and
red wine, that may not be a problem at other times of the month, may
also influence headaches.

From an NCBI abstract ? The headaches develop during the adaptational
period of oral contraception and the migraineous attacks occur in the
premenstrual period or at the beginning of menstruation which refer to
an oestrogen withdrawal character. It may be supposed that
vasoconstriction of certain extent, which has existed during the use
of the pills, changes over to relative vasodilatation in this period
and the extent of the changes is dependent on the oestreogen content
of the tablets.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2094059&dopt=Abstract

From the American Association of Reproductive Health Professionals:
?Neurologic disorders, such as migraine headaches or epilepsy, do not
preclude use of OCs. Women who have common migraine headaches without
neurologic symptoms may safely use oral contraceptives; some
migraineurs even improve with OC use. However, monitoring is
recommended, as the frequency or severity of headaches may increase.
(Those who have migraines associated with menses often find a decrease
in symptoms because of an increase in estrogen levels.)?
http://www.arhp.org/healthcareproviders/onlinepublications/clinicalproceedings/successfulloccp/mar99b.cfm?ID=187

Contraception Online
?A worsening of headaches, either in severity or frequency, or the new
onset of headaches while using estrogen-containing contraceptive
methods requires an evaluation (including blood pressure measurement).
If migraine is diagnosed, clinicians should refer to the prescribing
recommendations above and counsel the patient accordingly.?
http://www.contraceptiononline.org/contrareport/article01.cfm?art=236

?Two to three times as many women as men have migraine, perhaps
because the fluctuation of hormone levels is a key migraine trigger.
The pattern of a woman's migraines may be affected by her menstrual
cycle and is often altered when she undergoes menopause. In addition,
pregnancy or the use of oral contraceptives may change a woman's
migraine symptoms or frequency?
http://www.mamashealth.com/migraine.asp



 ?There is some controversy as to whether women with migraines should
even be on oral contraceptives.?
http://www.womenof.com/Articles/hc062600.asp


Women who suffer from migraine headaches now have some choices :
Mircette, a newer low estrogen pill
From everything I have found, I would say switching to Mircette may
alleviate your problem. Of course, you need to discuss this with your
doctor. She or he will decide which OC is best for you according to
your medical history. (You?ll need to see your doctor for a
prescription anyway, so discussing your headaches and perhaps a change
in OC would be prudent) Your doctor can work out a safe schedule for
you where you continue taking Mircette the entire month instead of
having a week off, or taking a week?s worth of inert pills. Some women
take the pill continuously for 2-4 months, with no days off. Mircette
contains 0.02mg ethinyl estradiol, 0.01mg less than Yasmin containing
0.03 ethinyl estradiol.


About Mircette 
Contraception Net
http://www.contraception.net/oral_pill/mircette.asp
and
Doctor?s Guide
http://www.docguide.com/dg.nsf/PrintPrint/8116156D65A89D68852568A1006EAB66
and
Drug Digest
http://www.drugdigest.org/DD/DVH/Uses/0,3915,550329|Mircette,00.html
and
Mircette, manufactured by Organon
http://www.mircette.com/


Another option would be Progestin only contraceptives. 
Norplant is a progestin only birth control method consisting of 6
small matchstick sized rods,  implanted in the upper arm.
See a picture of the implants here:  
http://www.emory.edu/WHSC/MED/FAMPLAN/images/norplantpto.jpg
Depo-Provera, an injectable contraceptive, given every 12 weeks is progestin only.
http://www.depoprovera.com/


 Less reliable than other methods, progestin only may also cause
breakthrough bleeding. (Mid cycle bleeding) and headaches.
Planned parenthood
http://www.plannedparenthood.org/bc/cchoices.html
http://www.arhp.org/healthcareproviders/onlinepublications/clinicalproceedings/hbccp/cprog.cfm?ID=160


 ?The Patch?, which can also cause headaches, but to a lesser degree. 
About the Patch
http://www.fwhc.org/birth-control/patch.htm


You may want to consider using an IUD. Today?s IUDs are far safer than
those in the past.
The Association of Reproductive Health Professionals
http://www.arhp.org/ndicslides/slide0010.cfm
Reproductive Health web site:
http://www.rhtp.org/iuds/iud.htm

The Association of Reproductive Health Professionals? web site has an
interactive tool, which may be helpful in selecting an alternate form
of birth control, should you chose to do so.
http://www.arhp.org/patienteducation/interactivetools/choosing/index.cfm?ID=275


You may consider Seasonale, menstrual suppression for birth control.
Using this method, you?d only have four menstrual cycles a year! This
OC may be used in women with migraines, but discuss any concerns with
your doctor.
http://womenshealth.about.com/library/weekly/aa062402a.htm
and 
http://www.arhp.org/menstruation/
and
http://www.seasonale.com/hcp/about.asp
and
http://www.seasonale.com/updates/default.asp

Headaches are a common side effect with Yasmin, and other oral contraceptives.
http://www.drugs.com/yasmin.html

Yasmin can raise blood potassium
http://www.personalhealthzone.com/drug_side_effects/yasmin.html

I hope this has helped you in your search for a headache-free
contraceptive. I commend you for wanting to learn more about your
birth control choices and encourage you to discuss your newfound
knowledge with your doctor.

If any part of my answer is unclear, or if I have duplicated
information you may already have, please request an Answer
Clarification before rating. This will allow me to assist you further,
if possible.

Regards,
crabcakes-ga

Search terms
Oral contraceptives migraines
Mircette
Birth control methods 
estrogen migraines

---

Request for Answer Clarification by bambs-ga on 27 Jan 2004 06:06 PST

Hello crabcakes!

The most confusing part of this issue for me was that I was not
previously a migraine sufferer.  I know that many women who have
ALREADY had migraines shouldn't take the pill, or specific hormone
combinations, but I was unaware that I would have this reaction to the
Yasmin (other than my mother has migraines with aura occassionally).
How can you know or gauge what your side effects will be? Is there a
specific hormone which elevates migraine tendency/frequency?

To answer your question, my headaches only occur during the "active"
pills, and not when I'm actually menstruating. That being said, I will
certainly avoid Yasmin and other pills with similar make-up in the
future.

I have recently gotten a prescription for Mircette. I'm hoping it will help.
Thank you,
Bambs

---

Clarification of Answer by crabcakes-ga on 27 Jan 2004 08:48 PST

Hi bambs,

It seems that heredity may play a role in your OC related migraines.
You mentioned that your mother had them, and perhaps you were lucky
enough to avoid them untill they were precipitated by the birth
control pills.
"Sex, age, and genetics also affect the tendency to migraine. It is
thought that an inherited enzyme deficiency, possibly in
monoamine-oxidase (discussed later), plays a large part in the
inheritance of a tendency towards migraines."
http://www.craig-wood.com/rob/migr.html

Dropping estrogen can cause the headaches, and as quoted above From an
NCBI abstract ? The headaches develop during the adaptational
period of oral contraception and the migraineous attacks occur in the
premenstrual period or at the beginning of menstruation which refer to
an oestrogen withdrawal character. It may be supposed that
vasoconstriction of certain extent, which has existed during the use
of the pills, changes over to relative vasodilatation in this period
and the extent of the changes is dependent on the oestreogen content
of the tablets.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2094059&dopt=Abstract

Hope this helps!I also hope you see an improvement with the Mircette
prescription. I'm curious as to what your doctor had to say about this
subject. If you have any further questions, please ask for another
Answer Clarification before rating, which will close this question. I
will be happy to assist you further.

Regards,
crabcakes-ga

---

Request for Answer Clarification by bambs-ga on 31 Mar 2004 07:15 PST

hello again

update: so i had been on the mircette for two whole months
(migraine-free but all sorts of other annoying side effects) and on
starting my third month of pills, i began getting the migraines again.
 my doctor suggested nuvaring or the injections, both of which i am
hesistant about for different reasons. i will try ortho-evra next. 
whenever i try to research the new pills/patch on the internet, it
seems each woman has completely different side effects and issues with
each prescrition. i suppose that means you just have to try them all
out, which takes a real toll on your body. i know there are other
options in terms of birth control, but the main reason i started
taking pill years ago was for severe cramps, so i would like to stay
on them if at all possible.

any last insight would be appreciated!

thanks again,
bambs-ga

---

Clarification of Answer by crabcakes-ga on 05 Apr 2004 22:32 PDT

Hi again bambs! Its been a long time!

I'm not sure what to tell you now, as you are absolutely right - each
woman can react differently to all kinds of contraceptives. Seems the
trial and error method you are working on may be your best bet. One
caution...you may want to use a back up method (condom, foam) untill
you are well established on a permanent birth control routine.

I wish you the best!
crabcakes

Read www.migraine101.com

thanks, mrdoc-ga.

i read the article.  it didn't seem to explain whether you could use
the natural progesterone cream/oil while on bcp.  are there any drug
interactions?  at this point, i am also concerned about adding any
other unpleaseant side effects to my already worn-out body.  i know
some people gain quite a bit of weight from taking progesterone
injections.  is this similar?