Caution: Birth Control and Migraines Don’t Mix

Dealing with migraines is enough of a headache. But if you’re on birth control, it gets even more complicated. Women who get migraines and use newer forms of combination birth control, which involve two or more hormones, are at greater risk of blood clots and stroke, finds new research out of Brigham and Women’s Hospital. The risk is higher if you have migraines with aura—those delightful visual hallucinations that accompany your headache.

Researchers analyzed the medical records of 145,304 women who were using combination birth control between 2001 and 2012. They found that women with migraines had an increased risk of blood clots or stroke compared to women without migraines. A smaller subset, women with migraines with aura, were at even greater risk. The highest-risk group of all? Women who had migraines with aura who were also taking newer forms of combination birth control, such as YAZ, the patch, and the NuvaRing. According to the research, 7.6 percent of women with migraines with aura who used drospirenone-ethinyl estradiol (aka YAZ) were diagnosed with blood clots, compared with 6.3 percent of women with aura-free migraines who were also on the birth control (stats about women who fell into other groups who were diagnosed with blood clots haven’t yet been released).

The researchers stress that the data is just preliminary. But the study builds on decades of research linking migraines with aura to increased cardiovascular risk, particularly for women on birth control. Having migraines already puts you at risk of having heart problems, says Tobias Kurth, MD, adjunct associate professor of epidemiology at the Harvard School of Public Health, who was not involved with the study. And it’s well-known that blood clots are a potential side effect of using birth control. Together, migraines and birth control may increase your risk levels, says Kurth. That said, it’s important to note that the research may have some confounding variables. For instance, it’s possible that more people with migraines are prescribed the newer forms of birth control because so much research links the older forms with cardiovascular risk. When those people get a stroke or blood clot, it’s not clear if it’s caused by the new birth control or their pre-existing condition.

Kurth says that if you’re on birth control and susceptible to migraines, it’s best to discuss your options with your doctor. One thing to keep in mind: Lighting up puts you in even greater danger. If you suffer from migraines with aura and are on birth control, you absolutely have to stop smoking—or give up the oral contraceptives, says Kurth.

photo: iStockphoto/Thinkstock

More From Women’s Health:
5 Ways to Prevent and Treat Migraines
Sneaky Headache Triggers to Avoid
Side Effects of Birth Control

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5 Ways to Treat and Prevent Migraines

The symptoms of a migraine are bad enough on their own—but scientists say having serious headaches may leave a lasting mark on your gray matter, too.

According to a study in the Journal of the American Medical Association, women who have migraines are twice as likely as non-sufferers to show structural brain changes, or lesions, due to insufficient blood flow to particular parts of the brain.

For starters, women are three times as likely as men to experience migraines, which in part is due to females’ fluctuating estrogen levels, says David W. Dodick, M.D., a professor of neurology at the Mayo Clinic and president-elect of the American Headache Society. “Estrogen can have a profound effect on the brain, especially brain areas that process the symptoms of a migraine attack,” he says. And although men and young women can experience migraine attacks, too, the prevalence is much higher for women between the ages of 18 and 55 due to menstruation, pregnancy, lactation, and menopause—all estrogen-altering cycles, he explains.

The migraine-induced lesions, which look like small white dots on an MRI scan, result in part due to the way the brain receives blood from the body, Dodick explains. “As you go deeper and deeper into the brain, the blood vessels branch off smaller and smaller,” he says. “And if you have a lowering of blood flow—which is the case during a migraine attack—the deepest parts of the brain may not be able to get the blood it needs, which can damage that tissue.” Luckily, while freaky, these lesions don’t seem to effect long-term cognitive function or memory.

Want to alleviate your own migraine-related maladies? The first step is to recognize that the problem is more than just head pain. “Migraines are a brain disorder, not a headache disorder,” Dodick says. “A headache is just one symptom, just as sensitivity to light, difficultly concentrating, dizziness, and nausea are also migraine symptoms” Try these tricks for preventing and alleviating some of your side effects:

Track your Triggers
If you keep a journal, you may be able to pinpoint what causes an attack, and then learn how to avoid those behaviors. Anything that upsets the equilibrium in your body—whether it’s lack of sleep, ingesting certain foods or beverages, or taking specific medications—can trigger a migraine, says Dodick.

Pop a Painkiller
Treat the pain as early as possible and don’t wait for the ache to worsen before you take medicine, Dodick advises. The less frequently you are using painkillers, the higher the dosage you can take, he says. You can safely consume 400mg to 800mg of ibuprofen or Excedrin (acetaminophen, aspirin, and caffeine), which is two to four tablets, according to Dodick. If the pain doesn’t lessen after four tablets, talk to your doctor.

Try Biofeedback
As a non-drug alternative, practicing relaxation therapy techniques works as a good preventative measure for managing migraines, Dodick says. “Biofeedback is a way for an individual to control the level of excitation and body temperate through meditation and other practices,” he says. By better managing the physiological processes of the body, you can lessen the migraine side effects and reduce the rate of attack.

Add Supplements
Many supplements such as magnesium, riboflavin, coenzyme Q10 and butterbur (a plant extract) have been proven to reduce the frequency of attack, says Dodick. Natural remedies aren’t regulated like prescription medication, though, so check with your doctor before stocking your cabinets with any new over-the-counter options.

Move Your Body
For some patients, excess training can trigger a migraine, says Dodick, but for many, a good workout can keep the ache away. “Regular exercise has been shown as an effective way to prevent migraine,” Dodick says. “And if you can manage other risk factors like anxiety as well as keeping your weight down, you can reduce the duration of your systems and the frequency of your attacks.”

Image: Fuse/Thinkstock

More from WH:
Sneaky Headache Triggers to Avoid
How to Treat Head Pain
18 Best Supplements for Women

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Exercise Is Just As Good as Meds at Preventing Migraines

Migraine Relief
Photo: iStockphoto/Thinkstock

Don’t want to pop a pill? Hit the gym instead. Exercise is just as effective as drugs are when it comes to preventing migraines, according to new research from the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Treatments documented as effective in the prevention of migraines have, until now, included topiramate-based drugs (like the migraine-prevention medication Topamax) and relaxation exercises, but not exercise.

The study, published in the medical journal Cephalalgia, compared the effects of 40 minutes of exercise three days a week to the effects of the already proven migraine-prevention methods: performing relaxation exercises and taking topiramate. The study lasted for three months and follow-ups were completed after three and six months.

The number of migraines decreased in all three groups, with no recorded difference in the preventative effect between the three treatments.

But since exercise packs tons of other health benefits, why not strap on your running shoes?

Check out these other health benefits of exercise:

Why Your Body Needs Strength Training
6 Reasons to Run 

Brain Benefits of Cardio

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