Migraines affect many women of reproductive age, and hormone changes are known triggers. While clinical guidance often considers migraine history when prescribing estrogen-containing birth control,1 much less is known about how hormonal contraception might influence the initial onset of migraines. Understanding whether progestin-only birth control affects the likelihood of newly being diagnosed with migraines provides important context for contraceptive counseling.
We studied more than 2 million patients aged 15 to 49. We matched patients newly diagnosed with migraines between January 1, 2018, and December 31, 2023, with patients who had an office visit in the same month and who were of similar age, race, ethnicity, and hypertension status. We also accounted for social vulnerability and rurality based on residence, BMI classification, smoking history, prior pregnancy, and census region in our analysis. We ended the study period at the end of 2023 because oral contraceptives became available over the counter in 2024,2 reducing our ability to reliably identify users.
We found that patients who used intrauterine progestin-only birth control were 24% less likely to have migraines diagnosed within two years compared to patients without a history of birth control use, as seen in Figure 1. Similarly, patients who were on oral progestin-only birth control were 18% less likely to be diagnosed with migraines within two years, those who were on intramuscular progestin-only birth control were 15% less likely, and those on other routes were 13% less likely.
Because this study included only individuals without prior migraines, the findings reflect association with new diagnoses rather than migraine progression.
