Talking to Hart about hormonal birth control, migraine and stroke risk got me wondering what my risk really is. If it is low, multiplying the number by eight isn’t that big of a deal. Kersti explains this well in her comment on the post:
[T]he problem with statistics is that they’re misleading. 8 times more likely… 8 times what? You need to find out what the baseline actually is, and you need to find it out for your own ethnicity, gender, circumstances before you know if this is a problem. If for example the baseline is 10% then 8 times is pretty ghastly, however, if the baseline is 0.01% then you’re still at 8 times 99.92% likely to NOT get one.
I’m kind of embarrassed I didn’t think this through before I wrote the post. I’m always urging readers to think critically. No matter how much I recommend caution, I too fall into the trap of fear. “Stroke? Eight times more likely? No way!” is how I reacted yesterday.
According to the American Heart Association’s stroke risk factors, I’m at very little risk. That’s reassuring. I’ll talk with the doctor on Monday and see what she recommends.
Check out the this BBC article on understanding — and critically evaluating — statistics, which Kersti suggested.
As the frequency of my migraine episodes has reduced this year, I was finally able to tell that I always get a migraine the first and second or third day of my period. Today once again provided confirmation.
My plan was to try hormonal birth control, like the pill, as a preventive. Researching this post has me reconsidering. Turns out women with migraine who use birth control pills are eight times more likely to have a stroke than women who don’t. This applies to everyone with migraine, not just those with aura (who are twice as likely to have a stroke than migraineurs who don’t have visual auras).
Other treatment options exist. Most of them I’ve already taken without success. Magnesium, which I think is responsible for decreasing the frequency of my migraines, is a common treatment. Unfortunately I’m already at the highest dose of magnesium I appear to be able to tolerate without extreme nausea.
I found on headache specialist Christina Peterson’s website that a small study of black cohosh shows it may be effective in treating menstrually associated migraine. Because there has only been one study, there is no confirmation that it works. Nonetheless, I’ll be researching black cohosh extensively. It is in the same family as rununculus, one of my favorite flowers — maybe that’s a sign it will help my head!
I thought hormonal birth control would be the ticket. A stroke would certainly be worse than having two more migraines a month.
If your migraines are associated with your menstrual cycle, please let me know if you’ve found an effective treatment. Leave a comment below or respond to the forum post with your suggestions.
Lybrel, a continuous birth control pill that stops menstruation recently approved by the FDA, may help prevent menstrually associated migraines for some women. Hormonal birth control is often used as a migraine preventive. Many doctors prescribe that patients replace the sugar pills with active pills to suppress menstruation, thus lessening hormonal fluctuations.
Taken each day, Lybrel provides a continuous supply of hormones without a break for a period, ever. It seems creepy to me, but The Well-Timed Period quotes a report that says that periods aren’t as necessary as they seem. Also, I’m one of the few women who actually likes having a period. (Maybe you didn’t want to know that?)
Learn more about “menstrual management” under “How to Skip a Period” on The Well-Timed Period and pokearound the informative blog.