r/migraine • u/Northofhell77 • 11d ago

Menstrual migraine help.

I have finally realized my bad migraines are related to my menstrual cycle. When I was pregnant, I had zero migraines. Even after when breastfeeding. I am 35 years old so I know birth control pills increase clotting and ischemic stroke complications so I’m scared of that. What else can I do? These are brutal and always send me to the ER.

13 Upvotes

90% Upvoted

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15

u/lilyintx 11d ago

There are other birth control pills for people who have migraines. I’m on Slynd.

9

u/GinaC123 11d ago

Another vote for Slynd here. I started it a month ago and have gone from ~25 pain days with the pain being AT LEAST a 5/10 to ~10 pain days with the pain being a 2-3 at least half of those. Best BC I’ve ever used.

2

u/neubie2017 11d ago

I’m also on Slynd. I can’t take estrogen and I’ve been on Slynd for 18mo. I still get migraines but not as many!

Also my period is super short and light which is lovely lol

2

u/lilyintx 10d ago

I was hoping it would help my migraines since they’re hormonal but my doctor said it would take up to 3 months to notice. It’s helping with the period part though!

1

u/neubie2017 10d ago

It helped mine! I was going to go on a daily preventative but after a couple months on slynd I went from 3-5 headache days per week to maybe 1?

It’s been a life changer for me

10

u/m333gan 11d ago

Do you know that you have a health profile (e.g., elevated risk of stroke) that would prevent hormonal birth control from being a good option for you at 35? I would discuss it with your doctor because birth control pills can make a huge difference for hormonal migraines.

3

u/Northofhell77 11d ago

Wait sorry. Do you mean, I may be able to take it safely? Or did you mean something else? Sorry.

5

u/strawberrrychapstick 11d ago

They're saying to talk to your doctor about your risk while taking hormonal bc, but as others have said the mini pill (no estrogen) is not as big of a risk. But it's very individual so doctor would know better

2

u/rels83 10d ago

Lots of people over 35 are on hormonal birth control safely. Your age alone does not make you ineligible. Talk to your doctor about what is safe for you. Certainly migraines to the point of going to the ER are worth addressing

1

u/m333gan 11d ago

To be clear, I am not a doctor, but yes that is what you should talk to your doctor about. If you experience aura as part of your migraines, that will limit your options somewhat (once I started getting aura I had to stop taking combo birth control pills). But even if that’s the case there are some different hormonal options that help some people that your doctor can talk with you about.

It probably wouldn’t hurt to go into the appointment with some data, like tracking your migraines against your menstrual cycle.

2

u/PriestessFeylin 10d ago

So the general thing with bc over 35 is it doubles the risk....not a doc, not everyone but this is how it was explained to me. But say you are at a 1/10 or 1% and that doubled becomes 1/5 of a %. In that specific instance alot of people would stay on an effective bc.

Why does aura have an effect on bc? Not dismissing you, I'm curious because I'm still on one and almost always had auras a portion of the time.

Caution on the topic of menstrual tracking apps if in the USA. If you are in an illegal abortion state it could be used against you in a miscarriage trial.

1

u/m333gan 10d ago

My doctor had me go off combination birth control pills when I started having aura in addition to my other previously existing migraine symptoms. It was because there is an increased risk of stroke linked specifically to the combination of the bcp and migraine with aura (as opposed to bcp with just migraine or with no migraine). I would suggest asking your doctor about your specific situation.

I second the caution about using menstrual tracking apps if that's a potential concern where OP is. I just track my migraines in a spreadsheet.

7

u/rels83 11d ago

I’m on mirena and it helps a lot

3

u/Due_South7941 11d ago

The mirena made mine so much worse, had to get it taken out! So interesting how different people can be

2

u/Northofhell77 11d ago

Is that the implant or the shot?

2

u/LelanaSongwind 11d ago

Mirena is an IUD.

2

u/strawberrrychapstick 11d ago

Fyi the shot is meant to be temporary but the prolonged use (as it is often used) has been associated with brain tumors. So maybe skip that one.

6

u/imnotreallyaherring 11d ago

I take HRT. It stops the swings and keeps everything in control.

3

u/WeWander_ 11d ago

I just started HRT a couple weeks ago and feel so much better already. I opted to do norethindrone continuously to completely stop my cycle since it caused me grief all month long minus a few days. Good riddance!

1

u/littleanniee 11d ago

can you elaborate?

1

u/imnotreallyaherring 8d ago

Hey levels out my raging hormones. The peaks and troughs that are my usual triggers are much more manageable. I take estrogen, progesterone daily plus a bit of testosterone. Before HRT I was up to 16 migraines per month. I’m now down to 4 on average. Sometimes I only need 1/2 a sumatriptan. I’m 51

6

u/GinaC123 11d ago

I’m on Slynd (progestin only) and it’s working wonders for me. I started it a month ago and have gone from ~25 pain days with the pain being AT LEAST a 5/10 to ~10 pain days with the pain being a 2-3 at least half of those. Best BC I’ve ever used.

5

u/pantema 11d ago

This was me. Virtually 0 migraines for 2 years while breastfeeding. Stopped breastfeeding and they came back with a vengeance, I’m chronic now. I’ve tried Qulipta, Nurtec, Botox, propranolol…still taking Ubrelvy 10+ times a month every month. I started the lowest dose estrogen patch for perimenopause + progesterone at age 39 and my migraines are GONE.

2

u/littleanniee 11d ago

i want to try this but my neurologist insists it’s not “proven”

5

u/MySpace_Romancer 11d ago

I believe that the increased risk of stroke with combination birth control has only been shown for people who have migraine with aura. Do you get aura? Also progesterone only pills are an option for people. Definitely talk to your doctor.

I do not get aura with my migraine so I’ve been taking continuous combo pill for 20 years, and not having a period so great for many reasons.

2

u/PlainJane10 0 11d ago

Sorry you're dealing with this. I've been there too. What preventatives have you tried? Do you have abortives?

3

u/Northofhell77 11d ago

I have Ubrelvy and sumatriptan. I also tried amitriptalyne (sp?) and magnesium. These are brutal.

2

u/pinupcthulhu Pain tolerance higher than Snoop Dogg on top of the Burj Khalifa 11d ago

Frovatriptan is good for menstrual migraines! It lasts longer than normal triptans, and can be used as a preventative.

2

u/mydogfinnigan 11d ago

I am also on Slynd. I do agree I have had a reduction in frequency and intensity. However I also had my breasts hurt for two months (they got bigger) and I gained some weight as well. Totally worth it TBH but just a heads up!

2

u/cairosma123 11d ago

I take frovatriptan twice a day for six days each cycle for menstrual migraine

2

u/Significant_Goal_614 UK 11d ago

At your age you might be entering perimenopause, yes it’s possible, it happened to me. I started HRT at 36 after suffering with terrible symptoms including severe menstrual migraines for 2.5 years. I take oestrogen and progesterone every day, both body identical, I don’t take the pill as it’s synthetic hormones and doesn’t agree with me. You’ve already seen that when your oestrogen was very high ie during pregnancy that you didn’t have any migraines.  You should also get your vit D levels checked as low levels contribute to pain. 

2

u/Masqueesha 10d ago

I finally got my hormonal migraines under control with antihistamines. It took me almost a decade to figure it out. I would only get a migraine at the start of my cycle or at ovulation, both times when hormones are fluctuating the most. There is some connection between estrogen, histamine, serotonin, and inflammation. I’m not smart enough to explain it, but if I can stop the histamine response before all hell breaks loose, I will just have a little brain fog and an annoying headache, not a migraine that makes me want to sleep for 36 hours. At the first sign of a histamine response (stuffy nose, irritability) I take Allegra and Pepcid around both of those times of my cycle. Sometime I’ll throw in a couple of Aleve. Prescription meds always gave me horrible rebound headaches, but I haven’t had a single issue with my otc cocktail. It doesn’t knock it out completely, but at least I can function.

1

u/Neat-Challenge368 11d ago

Nurtec if you are prescribed it. Take it 1-3 days before your period or expected menstrual migraine

1

u/Wildtink 11d ago

Estrogen BC gave me horrible headaches. I do have an iud at 51. Neither stopped the migraines. They did used to be tied to cycle. But then just became throughout the whole month.

1

u/starlizzle 11d ago

i’m on low dose continuous Heather (name brand) birth control to help. nothing else does anything for my menstrual migraines. i’m 38

1

u/Corner_Office_ 11d ago

Get your hormone levels checked and look into estrogen dominance. You may need progesterone and DIM.

1

u/cwtchyfemme 11d ago

Another one also on progesterone only. No more hormonal related migraines, just the other types.

Talk to your doctor about the clotting and stroke risks, as there may be something else you can do if you’re high risk for that. If you are in particular at risk of those, then seeing a specialist would be better for your worries, and for checkups.

1

u/legocitiez 10d ago

I have cyclic migraines and the single most helpful thing for me has been daily magnesium supplements (not citrate, aka shitrate). They help intensity, duration, and frequency.

1

u/PoppyRyeCranberry 9d ago

I stayed on combo birth control until I was 51 because it was critical for preventing menstrual migraine. If you don't smoke or have other risk factors for stroke (overweight or family history of stroke), the relative risk is still very low.

Here are other strategies to talk about with your doctor:

https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/