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Ashley with Planned Parenthood of the Pacific Southwest shares her experience with birth control as a migraine sufferer.


Birth control has always been a challenge for me thanks to the fact that I have suffered from migraines with an aura since I was nine-years-old. Because I have an elevated risk of stroke due to my migraines, it means I am limited in the birth control options I can choose from. In case you’re one of the 37 percent of reproductive-age women in the U.S. who are in the same boat, here’s my experience with birth control so far.

Let’s start off with what the birth control options, which involve low-to no-hormones to reduce the risk of a stroke, look like when you have migraines with an aura. They range from barrier methods and sterilization to the Depo-Provera shot, IUD, implant and mini pill. These options are vastly different and suit nearly any lifestyle, so while migraine sufferers are limited to certain types of birth control, there is still a nice range of options to choose from.

Let’s get a few things out of the way. Sterilization is not an option for me because I want to have children. Condoms are always a must to protect myself against STDs no matter what other method I’m using. And I am not up for using the cervical cap, sponge or internal condom. In my opinion, those methods are just too high maintenance for me. Plus, I am looking for a method that is easy to use, doesn’t require much maintenance and is highly effective.

I would venture to say that the mini pill isn’t for me. That is mostly because the mini pill should be taken at the same time every day for maximum effectiveness, and if you’re more than three hours late taking it, then you should use a backup method. While it’s effective, there is plenty of room for user error – if you’re anything like me, that is. As a right-brained individual, I can barely remember to make it to the appointments I have scheduled in my calendar. Let’s just say, I’m not a planner nor detail-oriented, so that option is a definite no.

I will add here that I have tried the mini pill (more on that later), and I failed miserably at maintaining it. However, some women do manage to stay on top of it, so, kudos to them!

The IUD and implant, which are both long-term (we’re talking upwards of three years in most cases), 99 percent effective and don’t involve having to remember to take a pill, are much more attractive methods for me. However, I’m not on board with having an object inserted into my body, let alone my uterus. It’s not that I find these options unsafe, but I’m actually just a tad squeamish about the insertion. So I have yet to try the IUD or implant.

And then there is Depo-Provera – a shot that you get every three months that is super effective (less than one woman out of 100 will get pregnant, if they use it correctly). It doesn’t involve taking a pill or inserting anything into your body for the long term. This option thus far has been my favorite.

However, it does involve getting a shot, so if you’re not into shots then it might not work for you. When the shot is taken in the arm it hurts (A LOT), but when the shot is taken in the hip you can barely feel a thing. It feels just like a pinch, I promise! You can ask for the shot in your hip, and I totally recommend it.

How does the shot work? It’s simple: you see your provider every three months, get a shot, and then you’re on your way. The best part of my experience with the shot was that after a few months of light bleeding, I had no period at all. I no longer had to worry about my period, and as a very active woman, it was the best feeling EVER. I’m not going to lie and say there weren’t moments when I freaked out about not having a period, but I eventually made peace with it.

It was such a good form of birth control for me, in fact, that I stayed on it for about five years with little to no side effects. During my last year on the shot, I began to experience mood swings and migraines, so my provider recommended that I come off of it. I was bummed, but it was for the best.

Afterward, I gave the mini pill a go for a few months, which also kept my period at bay. However, I continued to experience similar side effects as I had with the Depo shot, so my provider recommended that I come off of that as well.

While it’s possible that one day I will reconsider the IUD or implant, at this time neither is the right option for me. Today, I practice fertility awareness. It involves keeping track of your menstrual cycle, like when you ovulate and when you get your period, to avoid pregnancy. A barrier method like using condoms is definitely a must because fertility awareness is not the most effective method in comparison to the IUD and Depo shot. However, this was a method my partner and I felt worked best for us.

I use the calendar method (but you can also use apps), which involves determining the days during the month that I am fertile. I have found that natural family planning is relatively effortless for me because my cycle is like clockwork it comes every 28 days.

I am able to accurately estimate the day of my period and when I begin to ovulate. On top of that, I have a fairly uneventful period, so it’s not like I was using birth control to alleviate period symptoms like cramping and bleeding (as some women do).

Side note: One thing I have noticed is that I am back to getting my hormonal migraines, which were alleviated (and almost completely eliminated) when I was taking birth control. So if that’s why you’re taking birth control, then you might want to stick to it. At the moment, my migraines are fairly rare (knock on wood), so I figure I can tolerate a migraine at least once a month.

I’m not going to pretend that what works well for me is going to work well for everyone, especially those with migraines. I encourage you to keep looking and talk with your medical provider until you find the right one. After all, every woman’s body and lifestyle differs. So whether or not you have a pre-existing condition like migraines with an aura, it’s important to ask questions, know your options and find the best method of birth control that suits you and your lifestyle.

The views and opinions expressed in this article are those of the author. This content is provided for informational purposes only and should not be construed as medical advice or an endorsement by Planned Parenthood. Check with your health care provider to discuss what is best for you.


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