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Birth control question
An_197889 posted:
Our daughter is engaged and just started taking birth control this week (Avianne). She has not had migraines in 5 years. Within 2 hrs. of taking Avianne, she had the most severe migraine in those yrs. and was throwing up as well. Can you recommend a birth control that may not cause these symptoms? She is looking for a low cost birth control that does not have as many side effects. She tried it again the second day with the same effects. She has migraines with auras as well. Since moving to Colorado from the South 5 yrs. ago, she has not had migraines until now.
Jane Harrison Hohner, RN, RNP responded:
Dear Anon: Given that she has migraines with aura and a very severe migraine in response to using one of the lowest dose combined estrogen plus progestin birth control pills (BCPs) she may not be a candidate for "regular" BCPs. My best GUESS is that she may have been put on this pill because her GYN heard about the severe migraines in her health history.

So where does this leave her? Here is a partial list of some options for birth control:

1. Progestin only "mini pill"--these have 1/3 the amount of progestin and zero estrogen (estrogen is thought to be the migraine culprit). Mini pills are slightly less effective but still have the convenience of a pill.

2. IUD--this could either be the progestin IUD {"Mirena") or the copper IUD ("Paragard"). Very reliable, but each has it's own pluses and minuses.

3. Implanon--another progestin only method, it is very reliable and involves an implant in the arm.

4. DepoProvera low dose--all progestin, very reliable but can have breakthrough bleeding--which is consistent with other progestin only methods.

PLEASE urge your daughter to go back to her GYN or local family planning clinic right away. She should not continue with her Avianne without consulting with her GYN. Most likely they will want her to return to clinic for a discussion of other contraception options.

An_248145 replied to Jane Harrison Hohner, RN, RNP's response:
I too have this problem with migraine headaches while one a low dose combination pill, and my doctor told me after i'm done my last pack to switch to a progestin only pill. However the migraines in the last couple of days have been unbearable and i'm not sure if its safe to stop taking the combination pill mid-pack? And if I do, when do I start taking the mini pill? Imediately? Thanks for any help on this!

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