Kristina M. Tocce, MD, is a Fellow in Family Planning in the Department of Obstetrics and Gynecology at the University of Colorado, Denver, School of Medicine.
Stephanie B. Teal, MD, MPH, is Associate Professor and Director of the Program of Family Planning in the Department of Obstetrics and Gynecology at the University of Colorado, Denver, School of Medicine.
Dr. Tocce serves as a speaker and is a certified Implanon/etonorgestrel implant instructor for Merck. Dr. Teal is a consultant to Bayer Healthcare and a speaker for Merck.
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.
