How do you counsel patients interested in estrogen containing oral contraceptives who have migraine with aura?
Outside of patients whose attacks are suggestive of hemiplegic migraine, I do not typically avoid the use of estrogen-containing OCPs.
While it is my understanding that a number of international organizations and many neurologists (as well as Ob/Gyn) recommend their avoidance, there are several revi...
I typically educate (and document) the possibility of stroke from this combination and counsel on using low or no estrogen OCPs as much as possible. I also make sure to ask (and document) about their tobacco use, as this increases the risk significantly of OCP use with migraine + aura.
Hormonal therapies for contraception, PCOS, endometriosis, menorrhagia, dysmenorrhea, menopause, etc., do not fit a one-size-fits-all paradigm. For some women, IUDs or implants are not a good solution. For others, estrogens are difficult to tolerate, and for others, progesterone is difficult to tole...
There are a few different things that I would take a look at, such as how well the migraine with aura is controlled, and what estrogen-containing oral contraceptive is needed for. If it is pregnancy prevention, I would consider trying something different but if it is for a medical condition, then I ...
When you have a migraine, whether it is with or without aura, episodic or chronic, it is not a good idea to use estrogen-containing birth control and there is also no need, given the availability of progestin-only contraceptives. Estrogens are bad for headaches in general and for migraine in particu...
I strongly advise them against the use of oral contraceptives since there are better contraception methods.
I suggest to them:
- The contraceptive implant (Nexplanon) which is a small flexible plastic rod that's placed under the skin in the upper arm by a doctor or nurse. It releases the hormone prog...
While numerous responders have stated practices to avoid combined OCPs, none have made a clear argument based on reliable data and physiology to justify the position. Can someone in the camp who strongly avoids them please try to lay out the strongest argument for that position to help facilitate a ...