What about women who do notice a connection between hormone fluctuations and headaches? Will their headaches worsen on OCs? Based on studies done in the 1960s by Dr. Brian Somerville, it is thought that the drop in estrogen levels that occurs a few days before a normal menstrual period increases susceptibility to headache in some (but not all) women with migraine. Specifically, is has been suggested that the decrease in estrogen levels primes cranial vessels for certain chemicals such as serotonin. These women are more likely to have headaches during the week when they are off OCs, when estrogen levels fall.
Some women notice no change in their headaches when they are on OCs, and other women notice an improvement in their headaches when on OCs. Switching to a pill with a different dose or type of estrogen can also change headaches (make them better or worse). If headaches are a problem only during the week off OCs, it is possible to take the OC continuously, skipping the placebo pill or pill-free week. Doing this will cause women to have unpredictable light spotting for a few months, usually followed by minimal bleeding. Most gynecologists are familiar with using OCs this way to treat endometriosis, and are comfortable doing it for women with headache problems as well. The drawback to continuous use is that women will not have monthly withdrawal bleeding, which many women find reassuring as evidence that they are not pregnant.
Why is headache associated with oral contraceptive use?
Will using oral contraceptives make my headaches worse? What are some effective treatments?
Will using oral contraceptives increase the risk of stroke?
Reprinted from the web site of the American Council for Headache Education (www.achenet.org)
