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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]My periods used to be like yours and I’m now on birth control pills that make it almost completely nonexistent. I don’t understand why people think they have to live like this.

And believe me, I get it. With periods like mine used to be, no, you cannot just put a couple OB’s in your pocket. An OB was a joke. I could not be away from a bathroom for more than 45 minutes and I get that’s a huge pain with ski equipment and clothes. Learn from this vacation and start exploring options when you get home (my “last straw” was when mine came on a weekend I had a golf tournament and an outdoor concert and it was a total nightmare).

Oh, my doctor had me try taking Advil around the clock. Like 800mg in a sitting. It can slow down the blood flow. It’s not a long term solution but something easy you can try this week.  [/quote]

Note: [b]women who suffer serious migraines should not take birth control due to risk of stroke. [/b][/quote]

This is wrong.

The risk is for women who have migraines with aura, and only with estrogen-containing contraception.

1. If you have serious migraines but no aura, there is no increased risk.
2. If the birth control does not contain estrogen, there is no increased risk. Options include progesterone-only pills, DepoProvera shots, and Nexplanon subdermal implants, among others.[/quote]

Even some neurologists consider this outdated thinking. My neuro had no issue with me taking combination birth control pills despite migraine with aura. He said newer studies have shown that the current lower dosages of estrogen may not carry the same risk and the risk is still low. I took them for 5 years with zero issues. [/quote]

Sure, you can take the risk (and the data is mixed), but the guidelines haven't changed yet. Just know that taking estrogen with a history of migraine without aura is STILL recommended against by the American Academy of Neurology, the American College of Obstetrics and Gynecology, the American Academy of Pediatrics, and the International Headache Society.

[quote][summary article from 2018 in the journal [I]Stroke[/I]]
Migraine, OCPs, and Stroke Risk

Data linking stroke and OCP use in patients with migraine is limited and conflicting. The International Headache Society reports that patients with migraine (with or without aura) have an odds ratio of 3 for ischemic stroke; however, that risk increases to 6 in patients who have migraine with aura.1 Furthermore, the odds ratio for ischemic stroke in patients with migraine (with or without aura) using combination OCPs increases to 5 to 17.1 In contrast, both the World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception and a 2000 meta-analysis failed to find a significant effect of migraine (these studies did not differentiate migraine with or without aura) on ischemic risk in combined OCP users.1,8 The presence of additional stroke risk factors further increases risk of stroke with migraine.1

International Headache Society guidelines find no contraindications to combined OCP use in patients who have migraine without aura or lack other stroke risk factors (diabetes, hyperlipidemia, hypertension, smoking, and obesity).1 Use of nonestrogen contraception, such as an intrauterine device, progestin injections, or progestin implant, is recommended for women with multiple risk factors for stroke. These guidelines warn of a potential increased risk of stroke in patients who have migraine with aura, but there are no specific guidelines to not use OCPs in these patients.1 The American College of Obstetricians and Gynecologists guidelines further recommend, clinicians consider progestin-only (pill, IUD, injection, and implant) or nonhormonal (copper IUD, surgery, and barrier) contraceptive methods to women with migraine with focal neurological signs (for example, hemiplegic migraine), women ?35 years of age, and smokers.4

https://www.ahajournals.org/doi/full/10.1161/strokeaha.117.020084[/quote]

So, the major guidelines still recommend against estrogen in those with history of migraine with aura, but that's not the whole story. Also, pregnancy has a higher added risk of stroke than what *might* be conferred by today's lower dose combination OCPs, so, there's that.

Regardless, everyone agrees it's not an issue for "serious migraines" without aura. That's clear.

From above link,

[quote]TAKE-HOME POINTS

- Modern combined oral contraceptive pills have a lower dose of estrogens and less risk of stroke than older contraceptive formulations

- The risk of ischemic stroke in patients using combined oral contraceptives is increased in patients with additional stroke risk factors, including smoking, hypertension, and migraine with aura.

- The risk of ischemic stroke because of combined oral contraceptive pills is less than the risk associated with pregnancy.[/quote][/quote]

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