It is pretty common, especially among women, to get migraines. Usually a migraine is headache type pain that affects half the head and lasts from 1 - 72 hours. It is associated with de nausea, vomiting, and sensitivity to light, sound, or smell.

Migraine with Aura

Migraine with aura is a rarer subtype of migraine in which you have some additional symptoms, usually before or after your migraine. These symptoms range from seeing sparks, bright dots, and zig zags to tingling on one side of the body or an inability to speak clearly, and they usually last 20-60 minutes. 

If you have ever had this type of symptom, whether associated with birth control or not, it can mean that you may be at increased risk for stroke. You can even see how some of the symptoms almost seem like a mini-stroke. 

The risk is pretty small for most young healthy women but it is higher than normal. 

Migraine with Aura and Estrogen

However, in combination with an estrogen (usually as ethinyl estradiol) in combination birth control (the most popular type of pills) the risk of stroke can increase significantly.

This risk is high  enough that the official government recommendation of the CDC (Centers for Disease Control), the World Health Organization, and ACOG (the American College of Obstetricians and Gynecologists) recommend that you should not take estrogen containing birth control like combination pills. 

What Can You Use for Birth Control?

There are still a couple great options for birth control. 

Long Acting Options

Some of the safest and most effective types of birth control like both the copper and the hormonal IUD are safe to use with migraine with aura. They are super effective options and you can find out more about them by talking to your doctor or at BedSider. Since they require an in-person procedure we don't offer these on HeyDoctor.

Progestin Only Pills 

Progestin-only pills (POP), also called mini-pills, are a less common but great option. With the progestin-only pill you take an active pill every day, even during your period. Most people notice that for the first couple of months they may have a slightly heavier period, but after 6-9 months their periods are usually much lighter or go away. The progestin-only pill is safer for everyone, but especially may be a good option for women who smoke or have other risk factors.

Do I Have Migraine with Aura?

We can't diagnose you for sure with migraine with aura, but we try to help catch if you might have it. If you are unsure if you have migraine with aura make sure to talk to your primary care doctor or a neurologist (brain doctor) who can help diagnose whether or not you have it. 

Other Risk Factors

Other risk factors like smoking can significantly increase the risk of stroke for those with migraine with aura, and those without. If you are ready to quit smoking or to think about it make sure to talk to your doctor who can help you quit and stay quit. 

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