Migraine: Pregnancy, Contraception and Other hormonal factors

Question 1

How is Migraine during pregnancy managed?

Answer 1

First line - Paracetamol

Second line - Aspirin 300mg or ibuprofen 400mg (used second line in the first and second trimester)

Question 2

If someone has migraine with aura what does this mean for the COCP?

Answer 2

The COCP is absolutely contraindicated due to risk of stroke.

Question 3

Many women find that the frequency and severity of migraines increase around the time of menstruation. What is the management for menstrual migraines?

Answer 3

• Mefanamic acid
• Aspirin + Paracetamol + Caffeine
• Triptans are recommended in the acute situation.

Question 4

Is HRT safe to prescribe for patients with a history of migraines?

Answer 4

Yes but it may make them worse.