Reader's Mail: Are Contraceptive Pills Safe If You Have a History of Migraine?

Q. Is it safe to take combined contraceptive pills if you’ve had any history of migraine? I rarely get headaches, and I’ve probably only had three or four migraines with aura in my life.

A. Combined oral contraceptives have a small increased risk of stroke with a greater risk in those who have migraine with aura.  It is currently recommended not to use estrogen-containing combined oral contraceptives if you have migraine with aura.  Estrogen-containing oral contraceptives should be avoided if one has a history of blood clots or several risk factors for stroke such as smoking, high cholesterol, high blood pressure, or a family history of stroke or heart attack.  

Vincent Martin, MD
Headache and Facial Pain Program
University of Cincinnati Neuroscience Institute
Cincinnati, OH

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