Migraine & contraception
Start your consultation ›Choosing contraception is an important decision, but if you experience migraines — particularly migraine with aura — some options may not be suitable. Hormonal contraception can affect migraine: for some it improves symptoms by stabilising hormones, for others it triggers more frequent or severe attacks.
Understanding the link between migraine, hormones and contraception helps you choose the safest, most effective option for you.
It depends on the type of migraine. With migraine without aura, many women can safely use combined hormonal contraception after an individual risk assessment. With migraine with aura, combined (oestrogen-containing) contraceptives are generally not recommended because they may increase the risk of ischaemic stroke — safer alternatives include the progestogen-only pill, implant, hormonal coil and copper coil.
Migraine with aura carries a small increase in stroke risk, and oestrogen-containing contraceptives slightly increase the risk of blood clots and stroke too. Combined, the overall risk becomes higher than is considered acceptable when safer options exist.
Combined hormonal contraception may be an option if you have no additional risk factors, after an individual assessment. A clinician will consider your age, smoking status, blood pressure, weight, family history and migraine frequency.
Combined hormonal contraception is generally not recommended, because of the increased risk of ischaemic stroke. Progestogen-only and non-hormonal methods are usually preferred.
These options contain no oestrogen (or no hormones at all), so they are generally suitable even if you have migraine with aura.
No oestrogen, and suitable for most women with or without aura. Some notice fewer hormonally-triggered attacks thanks to steadier hormone levels.
Releases a small amount of progestogen locally. Highly effective, reduces heavy periods, and lasts 5–8 years depending on the device.
Completely hormone-free, ideal if you prefer to avoid hormones. Provides contraception for up to 10 years depending on the device.
Releases progestogen continuously, over 99% effective, lasts up to 3 years, and suitable for women with migraine with aura.
Progestogen-based and generally suitable with migraine, though long-term use can affect bone density — your clinician will weigh the balance.
If you develop migraine with aura for the first time after starting combined hormonal contraception, contact a clinician. They will usually recommend stopping the combined method and switching to a safer alternative. Watch for:
If you have migraine with aura, reducing cardiovascular risk is as important as choosing the right method — it supports both migraine control and long-term vascular health.
Can I take the combined pill if I have migraine with aura?
In most cases, no. Combined hormonal contraception is not recommended for women with migraine with aura because of the increased risk of ischaemic stroke. Progestogen-only methods are generally preferred.
What is the safest contraception if I have aura?
For most women, the safest options include the progestogen-only pill, hormonal coil, copper coil and contraceptive implant. Your clinician can help determine which is most suitable for you.
Can contraception make migraines worse?
Yes. Some women notice migraines become more frequent or severe after starting hormonal contraception, while others find they improve. If your symptoms change significantly, arrange a review with your healthcare provider.
Should I stop my pill if I develop aura?
If you develop aura for the first time while taking combined hormonal contraception, seek medical advice promptly. Your clinician will usually advise stopping the combined pill and switching to a safer alternative.
Does the progestogen-only pill cause migraines?
The progestogen-only pill does not usually increase migraine risk and is considered suitable for women with migraine, including migraine with aura. Some women find their migraines improve thanks to more stable hormone levels, although individual responses vary.
Can migraine affect fertility?
No. Migraine itself does not reduce fertility or make it harder to become pregnant. Choosing the right contraception and managing migraines well can, however, improve quality of life and support reproductive planning.
Migraine and contraception are closely linked because hormones influence how often and how severely attacks happen. Women with migraine without aura can often use combined contraception after an individual assessment, while women with aura are generally advised to avoid oestrogen-containing methods because of a small but important increase in stroke risk.
Fortunately, highly effective alternatives — the progestogen-only pill, hormonal coil, copper coil and implant — provide safe contraception for most women with migraine.