Migraine and Oral Contraception

Between 15% and 17% of Canadian women are afflicted with migraine at some point in their lives.1 Several internal and external factors can modulate the frequency and severity of the condition. In women, variations in the hormonal milieu—from puberty to menopause—have a definite influence in the clinical expression of migraine. Migraine is more likely to be active at the time of menses, and for most women with migraine, pregnancy is associated with a reduced number of attacks. There are several ways to attenuate the potential effects on the infant that medications taken during breastfeeding for the treatment of migraine may have. Menopause can become a critical period, with an increase in the frequency of attacks in the perimenopausal period, and, in some cases, perpetuation of the problem after menopause with hormonal replacement therapy.