and Oral Contraceptives - Review Article
Initiation of oral contraceptive (OC) therapy in migraine
may worsen pre-existing migraine or change the pattern of the
individual migraine attacks. Many women experience no change
in their migraine and a few show improvement. Evidence is accumulating
that migraine increases ischemic stroke risk and that this risk
is higher in migraine with aura than in migraine without aura.
OCs also increase stroke risk, and the increased stroke risk
attributable to each of migraine and OC therapy may be additive.
The risk of ischemic stroke in young women is very low and likely
remains acceptably low in young women with migraine without
aura and in those with a simple migraine aura when OCs are prescribed.
However, the presence of a complex or prolonged migraine aura,
or of additional stroke risk factors such as increased age,
smoking, and hypertension likely increases the ischemic stroke
risk further in patients with migraine when OCs are prescribed.
Whether OCs can be prescribed safely for the patient with migraine
depends upon many factors including patient age, type of migraine,
and the presence or absence of other stroke risk factors.
J. Neurol. Sci. 1997; 24: 16-21