Migraine and contraception

About contraception and migraine

If you have migraine, there are several things to be aware of when it comes to choosing contraception. Migraine and hormones are known to be closely linked. This means that any contraception that contains hormones could have an impact on your migraine.

Some contraception contains high doses of the hormone oestrogen. This can potentially increase your risk of stroke, particularly if you have migraine with aura. Because of this, not all types of hormonal contraception are safe for everyone with migraine.

There are strict rules about contraception if you take sodium valproate or topiramate. These medicines are sometimes used to prevent migraine. They can cause harm to a developing baby in pregnancy. For this reason, if you are able to get pregnant, a doctor will only prescribe them if you agree to take contraception classed as ‘highly-effective’. Your doctor can tell you what types of contraception this includes, and what is safe for you.

Types of contraception

Types of contraception include the following.

• Combined hormonal contraception. This is contraception that contains both oestrogen and progestogen. It includes the combined pill, the vaginal ring and the contraceptive patch.
• Progestogen-only contraceptives. These include the ‘mini-pill’, implant, injection and intrauterine system (IUS or hormonal coil).
• Non-hormonal contraception. This includes barrier methods of contraception such as condoms and diaphragms. It also includes the intrauterine device (IUD or copper coil).

What contraception you can use if you have migraine

What contraception you can use depends on the type of migraine you have. When you see a doctor, pharmacy or other health service about contraception, it’s important to tell them about your migraine.

Migraine with aura

Migraine with aura is when you have warning signs before a migraine attack. These may affect your vision, speech or cause unusual sensations, such as numbness.

If you have migraine with aura, you should not take any combined hormonal contraception. This is because studies have suggested that the oestrogen in these types of contraception leads to a small, but significant increased risk of stroke.

Both migraine with aura and combined hormonal contraceptives are linked to a very small increased risk of stroke. But the two things combined makes the risk even bigger. It’s still a very small risk, but it’s important enough to be considered an unnecessary risk to take.

If you have migraine with aura, it’s safe to take progestogen-only contraceptives like the mini-pill, implant, injection or IUS. You can also use non-hormonal contraception.

Migraine without aura

If you have migraine without aura, you may be able to take combined hormonal contraception. It will depend on any other risk factors you have for stroke. These can include smoking, obesity, high blood pressure and family history of heart disease or stroke. If you have any of these risk factors you may be advised not to take combined hormonal contraception. You can still use progestogen-only or non-hormonal contraceptives as an alternative.

Let your doctor know if you start getting aura for the first time when using combined hormonal contraceptives. Your doctor may advise you to switch to another form of contraception.

Emergency contraception and migraine

Emergency contraception is contraception that you use after sex to prevent pregnancy. Emergency contraception includes:

• the intrauterine device (IUD or copper coil) – can be fitted within five days after unprotected sex
• the emergency contraceptive pill or ‘morning after pill’ – needs to taken within three to five days of unprotected sex, depending on type.

None of the forms of emergency contraception contain oestrogen. This means you can use any type if you have migraine with aura, or migraine without aura.

How contraception can affect migraine

Contraception may improve migraine for some people, whereas for others it can make it worse. It may also have no effect on your migraine at all. The effect of contraception on migraine is not predictable, and it can vary from person to person.

Talk to your doctor if you find your migraine gets worse when you start a new type of contraception. You should also tell them if you get migraine, or migraine with aura, for the first time. There are many different options for contraception if you have migraine. Your doctor can help to find a solution that works for you.

Combined hormonal contraception

If you have migraine linked to your menstrual cycle (menstrual migraine), combined hormonal contraception such as the combined pill may help. But it can also make migraine worse. It can depend on exactly what type of contraception you are taking and how you are taking it.

You normally use the combined pill every day for 21 days and then have a seven-day break. This break causes a sharp drop in oestrogen levels. This may trigger migraine attacks for some people. You may find your migraine attacks become more painful or frequent during this time. If this happens, your doctor may suggest:

• changing to a different type of pill with lower doses of hormones
• having fewer or shorter pill-free breaks, or taking the pill continuously without a break
• using an oestrogen supplement, like a gel or patch, during the break from your pill
• using another form of combined oral contraceptive, like the patch or vaginal ring
• changing to a different method of contraception.

The vaginal ring and patch are less likely to cause large changes in oestrogen levels than the contraceptive pill. This may make them less likely to trigger a migraine attack.

Other types of contraception

The progestogen-only ‘mini-pill’ often helps to improve migraine. But it can sometimes cause prolonged, or irregular bleeding.

The IUS or hormonal coil, which only contains progestogen, may sometimes stop your periods. It’s possible that this may lead to a reduction in migraine attacks. However, there is little information about this, so more research is needed.

The IUD or copper coil does not contain hormones. However, it can sometimes cause periods to become heavier or longer. There is no clear evidence whether this has a direct effect on migraine.

We have further information on Migraine and birth control for young people.

About our information

This information has been written by The Migraine Trust Information and Support Services team. It has been reviewed by our panel of expert health professionals and people affected by migraine.

Our information has been awarded the PIF TICK quality mark for trustworthy health information.

If you have feedback on our information, please get in touch at: feedback@migrainetrust.org

References for our information are available on request.

Last reviewed: May 2025 | Next review due: May 2028