Prevention

Avoiding Oral Contraceptives

Hormonal drugs, such as oral contraceptives (OCs) or hormone replacement therapy, have a mixed effect on women with migraines. Oral contraceptives (OCs) have been associated with worse headaches in 18 - 50% of women and have also been linked to a higher risk for stroke in women with classic migraines (with auras). Young women should avoid or stop oral contraception if they have classic migraines, migraines that worsen or change character after OCs, if they have close relatives with stroke or heart disease, or if they smoke.

Some evidence suggests, however, that OCs may help prevent true menstrual migraines (which do not have auras). In such cases, their benefits may outweigh the low risk of a serious adverse event. Keeping a migraine record for at least three menstrual cycles can help confirm whether a woman actually has a true menstrual migraine.