I'm not sure if the information I'm reading about this on the internet is accurate. What is the risk of taking a birth control pill if you have migraines with or without aura?

Good morning, ma'am,

We often hear that taking birth control pills for migraines should be avoided because the risk of having a stroke increases. While this is the right thing to do in some situations, it is important to understand that it could be a treatment option in other cases.

In general, for a healthy woman under the age of 35 who does not smoke and does not have migraines, your community pharmacist can initiate oral hormonal contraception. However, if this is not the case, a more in-depth medical assessment is required.

There are several types of headaches, and the risk of having a stroke varies depending on the characteristics of the migraines. For example, the risk of having a stroke associated with a migraine without aura is not the same as for a migraine with atypical aura. For more details on this subject, you can consult this article by Le Médecin du Québec.

This article states that in women under 45 years of age, the basic risk of having a stroke is 5 to 10 per 100,000 women per year. This risk remains negligible despite the fact that migraine without aura would increase the incidence by 2 or 3 times and migraine with aura would double the baseline risk. Moreover, the risk associated with migraines with aura disappears after the age of 50 according to this article from Migraine Québec.

The risk of having a stroke becomes more worrisome when other risk factors are present, such as high blood pressure, smoking, personal and family history, etc. This is why the decision to prescribe or not a contraceptive treatment varies according to the case and the medical profile of the patient. The article by Le Médecin du Québec explains the different situations, the impact of risk factors and the elements to consider if treatment is initiated. One must always evaluate the risks (e.g. stroke) vs. the benefits (e.g. quality of life) of initiating treatment.

Hope this answers your question,

Samantha Hui, pharmacy student

Under the supervision of Alexandre Chagnon, pharmacist