I was prescribed the combination pill when I shouldn’t have been

I suffer from migraines and was prescribed the combination pill for years when I shouldn’t have been

Contraceptive pill

Recently I started going to a new doctor. What spurred me into that decision was the desire to finally get answers for what caused the painful, heavy periods I had been plagued with since my early teens. I told her the history of my period and its symptoms and my contraceptive use during my first visit.

When I first got my period at ten, I experienced pretty much no problems, the only symptom I had was bleeding. But when I was around thirteen, my periods became unbearable. Increased bleeding, anaemia and fatigue, doubled over in pain, severe PMS and mood swings, headaches and, most debilitating of all, migraines. My period lasted for about seven days and the PMS lasted for about seven days, so roughly half of every month was filled with physical and mental pain, taking a toll on my physical and mental health.

In the days leading to my period, I would have headaches that rarely went away with painkillers or even sleep. On the first day of my period, the migraine attack hit. In the minutes leading up to the attack, I would have vision disturbances, spots in my sight, everything seemed unreal until my vision completely blacked out, the muscles in my arms and legs would completely stop working and I would collapse, I had trouble speaking and intense head pain. The brief time I was unable to walk, talk or see would be followed by vomiting and sleep to recover.

The period migraines hit anywhere – at school, in crowded shopping centres, on the train forty minutes away from home with no one to help, in the car (then I’d need to pull over). Not to mention the other symptoms preventing me from fully functioning. It is barely an exaggeration to say my natural period was ruining my life.

Throughout my teen years, my mum and I saw doctors to find out what was the cause and how to manage my periods. Naturally the pill was suggested, as it commonly is with these issues, but for years neither my mum or I wanted that due to my age. Finally, around 16 or 17, I agreed to try the combination pill. I was prescribed a pack that contained four months’ worth. I took them for one month and didn’t notice a change in my period or symptoms so I stopped. A few years later, the three remaining months of pills were close to expiring and I thought I’d use them up before they expired. It turned out the desired changes to my period and PMS wouldn’t start until two months of being on the pill, I was just too impatient before, which my mum had suggested at the time but she didn’t push. Probably because she didn’t really want me taking hormonal contraception while I was still going through puberty.

So, for the past few years I have been taking combined hormonal birth control pills. Since taking them, my periods have been about twice as light and I’ve had very mild symptoms both during the period and PMS stages. It was of great benefit to my health and quality of life. Or so I thought.

Caitlin Goh.
Caitlin Goh.

On my second visit to the new doctor, they had looked over what I previously told them and asked me more about my migraine symptoms. They informed me that the neurological symptoms I had before the migraine attack were called an ‘aura’ and women who have migraines with aura shouldn’t take combined hormonal contraception because it can cause an increased risk of stroke. I felt like someone had just hit me with a bag of rocks. Not just because of the ‘increased risk of stroke’ but because I had been prescribed this type of contraception for years. By doctors.

Impatience is generally considered a negative trait but my impatience meant I only took combination pills for around two years as opposed to almost eight. My impatience may have decreased my risk of stroke.

I spent the following days and weeks seething that no doctor had picked up on this before. I’ve told every doctor I’ve seen about my periods and contraception, the symptoms I have from my period, especially the migraine symptoms, and every time I went to refill my prescription, the notes would be there on my file for them to see.

Worse yet, during the past few years I’ve taken the combination pill, I switched the type of combination pill I took to one with a lower dose of hormones due to other unwanted side effects. To make this change, I went to a family planning clinic and, in addition to my new issues, told the doctor I saw what happened during my period, including the migraine symptoms, when I wasn’t on the pill, and still they prescribed a combined hormonal pill. They didn’t seem to pick up on the ‘aura’ symptoms I listed. You’d think working specifically in the field of family planning would make them an expert.

Maybe I just never described the symptoms clearly enough. But if taking the combination pill can increase your risk of stroke if you have migraines with aura, shouldn’t that be one of the first things someone is asked when they see a doctor about the pill, especially if they mention they get migraines, like I did?

During my seething, I became concerned at just how common this is. How many other women and teenage girls who get migraines have had the exact same experience as me? More worryingly, without even realising the potential health risk they’ve been put in?

You should question your doctor about migraines, or any other health conditions, and safe contraception, even if you’ve been taking the same type of contraception for years. I believe one issue I had was once I was prescribed the combination pill, any doctor I saw, except my most recent one, assumed it was safe for me without reviewing. 

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