How to choose a contraceptive for a patient who has headaches
Developing an accurate diagnosis of headache subtype will help avert unnecessary restriction of hormonal methods among your patients who do not have “pure” migraine
IN THIS ARTICLE
Once you become aware of a history of headache, careful history-taking can usually differentiate between the major headache subtypes and help you avoid limiting contraceptive options unnecessarily.
Women who start any contraceptive may report improvement, worsening, or new onset of headache symptoms. This change usually occurs within the first 3 months, and headaches associated with hormone use tend to improve with continued use.21
In women who have preexisting migraine, you should undertake prompt evaluation and consider a change of contraceptive method in response to 1) any increase in severity or frequency or 2) the onset of associated neurologic symptoms.
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