Although OCs sometimes initiate headaches or make them more severe, headaches can also be a warning of impending strokes or other circulatory disorders. Pay close attention to headaches that are different or more severe than those you had before starting on the Pill.
Estrogen seems to be the culprit in Pillrelated headaches, so you might find relief by changing to a lower dose pill, or switching to a progestinonly method like Norplant implants or DepoProvera. If you usually get headaches only during the week you're not taking pills—the placebo week—you might have what's called an estrogen withdrawal headache. To determine whether this is the case, consider using an estrogen supplement. For example, during your withdrawal week, you can try wearing a transdermal patch that releases estrogen through the skin.
Another approach to estrogen withdrawal headaches is simply to put off withdrawal from the Pill. Essentially, you postpone the headache by extending the amount of time you take active pills. A recent yearlong study of 300 women showed that those who opted for an extended regimen—taking active pills for 9 weeks instead of 3 and then taking a withdrawal week—had fewer headaches. Continuing the active pills for the extra time caused no serious side effects and no decline in effectiveness.
It may seem unnatural to take pills for longer than the standard 3 weeks, but remember that the entire pill cycle is essentially unnatural. As one family planning expert puts it, “The day was made by God, the week was made by man.”
