Hormones play a major role in migraines for many people. Because of this, hormonal birth control can sometimes reduce migraines—but in other cases, it may make them worse. Understanding how your body reacts to hormonal changes can help you choose the right option.
Migraines affect about 1 in 5 women, and many notice changes in their migraine patterns when they start or stop hormonal contraceptives.
The hormone most closely linked to migraines is estrogen. When estrogen levels rise or fall—especially before menstruation—it can trigger neurological changes that lead to migraines. This is why migraines often worsen during a period, when estrogen drops sharply.
Can Birth Control Cause Migraines?
Yes, in some cases. Hormonal birth control works by altering your natural hormone cycle. For some people, this stabilizes hormone levels and reduces migraines. For others, hormone shifts—especially during the pill-free week—can trigger more frequent or severe migraines.
Estrogen-containing birth control can increase migraine frequency, especially for people who experience migraine with aura. A migraine aura is a set of temporary neurological symptoms—commonly visual, sensory, or speech disturbances—that occur just before or during a migraine headache. Affecting about 30% of migraineurs, these symptoms usually develop gradually over 5–20 minutes and last less than an hour.
Other migraineurs actually experience fewer migraines because birth control reduces natural hormone fluctuations.
The type of hormone and dosage also matter. Newer low-dose birth control pills (20–35 micrograms of estrogen) tend to cause fewer side effects than older, higher-dose formulations.
Combined Birth Control Pills
Combined pills contain both estrogen and progestin. While they are effective and widely used, they may not be ideal for people prone to migraines. Estrogen withdrawal during the placebo week can trigger headaches because hormone levels drop suddenly. Some people experience more migraines during this break.
To reduce this risk, providers may recommend options to help keep hormone levels more stable, such as:
- Skipping the placebo week
- Using an extended-cycle pill
- Choosing a lower-dose estrogen pil
Birth Control Options for People With Migraines
Many people with migraines can safely use birth control, but the safest choice often depends on migraine type and overall health.Estrogen-free methods are often recommended, particularly for people with migraine with aura. Options may include a progestin-only pill, a hormonal IUD with steady progestin release, a progestin injection every three months or a hormone-free copper IUD.
Migraines and Hormone Therapy During Menopause
Hormonal changes during perimenopause and menopause can also affect migraines. Some people see improvement after menopause, while others experience more unpredictable headaches during the transition.
Hormone replacement therapy (HRT) can help stabilize hormone levels, but the method matters.
For migraine sufferers:
- Transdermal estrogen (patches or gels) may be safer than oral estrogen
- Lower, consistent hormone doses are usually better tolerated
- People with migraine with aura should carefully review HRT options with a healthcare provider
FAQ
Which birth control is best for migraine sufferers?
Progestin-only options such as the mini-pill, hormonal IUDs, or the Depo shot are often preferred.
Can you use birth control if you have migraines?
Yes. Many people with migraines can safely use birth control, but the method should be selected carefully.
Why is estrogen birth control sometimes avoided?
Estrogen-containing contraceptives can increase stroke risk in people with migraine with aura.
Can you use a vaginal ring if you have migraines?
Because the ring contains estrogen, it may not be recommended for people with migraine with aura.