ABSTRACT
There are two, quite differing, oral contraceptives. It is important to establish which method a woman is using as each has different implications for migraine.
Combined oral contraceptives (COCs) (Figure 24) Headache is a frequent side-effect during the early months of COC use but usually resolves with continued use. With regard to migraine, COCs have a varying effect:
• No change • Improvement in migraine • Migraine in the pill-free interval • More severe/frequent migraine • Onset of migraine de novo • Onset of aura de novo
Some women report improvement but others note a worsening in frequency or severity of migraine with a tendency for attacks to occur during the pill-free interval.
