Migraines and oral contraceptives?

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    I have been on oral contraceptives for over 15 years with problems starting the past two years. I get a migraine when I'm on the sugar pills. I also got migraines at other times, but very infrequently. It is awful and lasts for a few days, and is quite debilitating. I went off the pill for one month and no migraines at all. But, because I was taking the pill for endometriosis and my period was VERY bad that month, I decided to go back on the pill (and visit my doctor). Since restarting the pill, I've had a migraine constantly for the past 2 and 1/2 weeks. I don't understand why going BACK on a pill would cause this. My doctor recommended I do the pill and have no break between periods, but I can't even get past the first two and 1/2 weeks. I had to stop the pill today, because I just can't take it. I wonder if taking a progesterone only pill would help the endometriosis and not be a migraine trigger. Jackie.

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    Dear Jackie;


    Unfortunately, progesterone alone is not considered as good as estradiol for endometriosis. I've heard of things like this (increased Migraines) after re-starting the OC. Often they soften up after a few weeks, so you may just be in the Migraine window. Sounds like you do have Migraines when the estradiol dose is stopped. Estrogen without a break can be a useful treatment for peri-menstrual Migraines (and endometriosis). The other option is to seek out a Migraine specialist and have her/him talk to your gynecologist. If you need help locating a specialist, there's a link below to our listing of patient recommended specialists.


    Good luck,
    John Claude Krusz and Teri Robert



    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    Last updated October 7, 2008.


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Published On: October 07, 2008