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Is the IUD an effective approach to contraception for women with migraines? #102/6

I am currently taking 200 mg of topamax/day to alleviate my migraines, and I have tried several different birth control pills. The most recent pill my doctor has prescribed is Necon, however, I feel as though this has caused my migraines to worsen. Last week my doctor suggested looking into an IUD and gave me this website to research. I am only 27 and am very frustrated with trying to find a pill that works for me. Is the IUD an effective approach to contraception for those with migraines?

Thanks. great website! 






It sounds as thought an IUD would be an excellent option for you and also as thought pills are not a good option for you. You could probably use either a copper T IUD (ParaGard) or a hormonal IUD called Mirena.

Look up three things on the website: www.managingcontraception.com

Migraines, ParaGard, Migraine headaches

The three following questions could offer some additional information:

Can the Mirena IUD be used by a woman who has migraines with aura?  She also smokes and is over 35 years of age.  Click here

Can a woman with migraines including aura, be prescribed combined pills after explaining the risks - if SHE wants to accept those risks? Click here

 

Could my IUD cause my migraine headaches to worsen? #720 Click here

Please tell me also:

Do you have bad menstrual cramps or pain?  If you do, this would suggest that MIRENA might be a better choice than a ParaGard.  How many children do you have and what are your plans for the future?  

Her answer:

            "I am 27 years old, I don't have any kids and we aren't planning for any children anytime soon.  My husband and I say we don't want kids, however, maybe when we are in our 30's we will change our minds.  As for cramps, I've been on the pill since I was 18 years old.  I don't really remember what it's like to have a "real" period."

            "My doctor suggested the ParaGard as my second option, but she would rather me try the Depo shot first. To see how my body would react to the Depo shot, she suggested trying a month of progesterone-only pills."

            "I haven't made a decision yet.  I will be discussing it further with my neurologist this week as well.  Thank you for looking into this."

            My response to her 3rd email:  Your contraception options now are:

  1. Depo-Provera: which may be beneficial if your migraine headaches seem to be cyclic, moreover the effectiveness of Depo-Provera is not elevated by antibiotics or psychoactive drugs.  If you get into your mid-30s and still want to have pregnancy as an option, switch to another contraceptive that lead to more rapid return of fertility.
  2. Progestin-only pills:  a perfectly acceptable alternative in terms of migraine headaches, but mini-pills are very low-dose and their effectiveness is compromised by all of the following drugs:

 

Carbamazepine (Tegretol)

                        Felbamate (Felbatol)

                        Nevirapine

                        Oxcarbazepine (Trileptal)

                        Phenobarbital

                        Phenytoin (Dilantin)

                        Primidone (Mysoline)

                        Rimidone (Mysoline)

                        Rifabutin

                        Rifampicin (Rifampin)

                        St. John's Wort

                        Topiramate (Topamax)

                        Vigabatrin                 

                        Possibly ethosuximide, griseofulvin, and troglitazone

 [Speroff, Darney A Clinical Guide for Contraception.  Fourth edition 2005, page 101]

 

            If you choose to use a progestin-only pill, you must use condoms in addition!

 

            You may use either a ParaGard or Mirena IUD.

 

Key Words:  migraines, topamax, Necon, IUDs, frustrated, mini-pills, progestin-only pills, condoms, ParaGard IUD, Mirena IUD

Robert A. Hatcher MD, MPH
Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2006-01-23


Managing Contraception for Your Pocket 2010-2012 #9005
  


Managing Contraception for Your Pocket 2010-2012 #9005
  

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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