People who get migraine with aura – dots or zigzags in vision, or another sensory disruption That typical takes place before the start of a migraine – has been told for a long time prevent Birth control that contains estrogen. The hormone is linked to an increased risk of stroke in this population.
How great is the risk, and what should you do if you are one of the 25% of it Women of reproductive age who get migraine? This is what doctors say.
The relationship between migraine and a stroke risk
For years, doctors and medical associations warned That people who get migraine with aura can have an increased risk of stroke if they take additional estrogen. Many forms of contraception contain estrogen – including some species contraceptive pillsthe contraceptive matchand the vaginal contraceptive. They are known as combined hormonal contraceptives because they contain two hormones: estrogen and progestine.
Combined hormonal contraceptives “are safe for most people”, according to the American College of Obstetricians and Gynecologists. But they are associated with a minor risk of stroke and that risk is higher in people with certain risk factors, such as people who get migraine with aura. People who get migraine with Aura already have a higher baseline risk of a stroke because they are more likely to form blood clots, according to the American Migraine Foundation, And estrogen supplements can increase the formation of small blood clots.
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“Estrogen-containing birth control can increase your risk of stroke independently of a stroke, and having migraine with Aura also increases your risk of a stroke independent of other risk factors, so combining those two risk factors is together as in risky,” Dr. says Dr. “Dr.” Dr. Franziska Haydanek, an OB-Gyn in Rochester, New York.
Determining your individual risk
However, some experts say that the risk for this population can not so high Like before. Dr. Jelena Pavlovic, a neurologist and headache specialist based in the Bronx, says that the recommendation that people experiencing migraine with Aura was established years ago, when the birth control methods on the market contain higher doses of estrogen. The contraceptives that are available today contain much lower doses of estrogenShe says, and “we have no updated, large -scale data” to evaluate the risk of these new formulations of contraceptives for people who have a migraine with Aura. Past research has indicated That in general people who have taken contraceptives with lower doses of estrogen, have a reduced risk of stroke compared to those who use methods with more estrogen. Other Medical experts also shared comparable thoughts About the current recommendations.
But that does not necessarily mean that people who get migraine with aura must use estrogen-containing contraceptives.
“If [with] Everything in medicine, the first rule is “don’t hurt,” says Pavlovic. “So we tend to be careful.”
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She says that the use of estrogen -containing contraceptives ‘must be considered on a case -by -case basis’, depending on the consistency, the severity and type of migraine that a person has. People must consult both their gynecologist and neurologist to discuss the options for birth control. If the migraine of a person is not evolving and are relatively well controlled, and if they have no other risk factors, such as smoking, they and their doctors can consider introducing lower doses of an estrogen -containing contraceptive and checking how it works.
Although high doses of estrogen can wear an increased risk of stroke, the hormone can also, at lower doses, also are used to treat and stabilize migraine.
“If a woman with aura with Aura is denied access to combined hormonal contraceptives because of very strict guidelines, she not only loses a contraception option, she may also lose a migraine treatment option,” says Pavlovic.
Other birth control options
If a patient consults with his doctors and they determine that his risk level is too high to use an estrogen -containing contraceptive, there are many other birth control methods that do not contain estrogen that they can use instead, including Only contraception pillsthe Birth control injectionAnd CoilAccording to Haydanek.
OB-Gyns have had in recent years pronounced concern About a wave of people who do not stop contraception and rely on “natural” methods that are less effective instead. Incorrect information About contraception regularly circulates on social media platforms, such as Tiktok.
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Although social media can help in sharing important health information, people should not only trust it, says Haydanek. Instead, she recommends that they consult their doctors if they have questions or have worries.
“In general, contraception is a very safe medication, but everyone’s own medical history clearly plays in it,” says Haydanek. “If [people] Ever worried about how contraception influences them or their risk, they really have to plan a problem with their OB-Gyn to really discuss those worries. “
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