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  • Title: Headaches: OCs are "guilty by association".
    Journal: Contracept Technol Update; 1993 Jul; 14(7):109-12. PubMed ID: 12286998.
    Abstract:
    Oral contraceptive (OC) users' leading complaint is headaches, but no study definitely links OC use to headache development or exacerbation. Unexplained headaches tend to begin in young adults, the same group that extensively uses OCs. Women suffering from tension headaches, caused by muscular contraception and not vascular effects, can use OCs. The decision to use or not use OCs is not so easy for women suffering from migraines, however, because migraines are hard to diagnose. They may have a vascular origin. Scientists do not really know the etiology of migraines. Some believe changes in estrogen levels contribute to migraines. For example, about 60% of women have a migrate during menstruation. A physician suggests treating such women with estrogen supplements during menstruation or with continual administration of monophasic OCs for 2-3 months with no withdrawal bleeds. Another physician asks OC users with headaches to keep a record of when the headaches occur and the conditions (e.g., time during menstrual cycle). Other alternatives are to switch OC users with headaches to progestin-only contraceptives. Family planning providers should not be concerned about women who have had a history of headaches before starting OCs. They should be concerned about those who did not have any headaches before taking OCs and then suddenly started having them after OC use. The former group of women are less likely to have a stroke, since a long history of headaches suggests that a vessel is not involved. Due to the legal environment, a family planning physician recommends that the provider talk to an OC user who has increasing headaches about other methods and possible risks. If an OC user begins having stroke like symptoms (e.g., visual symptoms when eyes are open and true vertigo), it is highly recommended to switch her to another contraceptive and have her undergo a neurological examination.
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