Birth control pills (oral contraceptives) are a safe and very effective method to prevent unwanted pregnancy. However, I observe that some of my migraine patients experience more frequent and severe headaches after starting a pill.
In addition, risk analysis should be done for migraine patients who will start birth control pills. Birth control pills are considered safe in migraine without aura . However, patients with migraine with aura who carry risk factors such as smoking, diabetes, high cholesterol level, high blood pressure and obesity, should avoid the use of oral contraceptives due to the increased risk of ischemic stroke. This risk is especially high in birth control pills containing estrogen, and there is no evidence that stroke is related to pills containing progesterone alone. In addition, we do not have sufficient data that hormone replacement therapy given for the relieve of menopausal symptoms increases the risk of stroke in migraine with aura.
If birth control pills increases the number of your migraine headache days, I recommend you to consult your Neurologist and Gynecologist. You might need to switch to an alternative method of contraception.