Headaches, upset stomach on the pill
Q: Dear Dr Mitchell,
I started taking Minigynon 30 contraceptives but I’m having terrible headaches, upset stomach and belly pain. Is this normal or do I need to stop taking this pill?
A: Minigynon 30 is a low-dose combined contraception that contains both oestrogen and progesterone. The number 30 indicates that it contains 30 micrograms of Ethinylestradiol (oestrogen).
In some instances there is associated minor stomach upset, nausea, bloating, vomiting and headaches in the first few months once the Minigynon is started. In some cases where symptoms are mild and can be tolerated, everything goes back to normal after a few months of taking these pills. However, severe headaches caused by the birth control pill should not be ignored.
In women who suffer from migraine and frequent headaches, going on the oral contraceptive pill can often aggravate these headaches. In severe migraine headaches the birth control pills or any other preparations containing hormones similar to the pills should not be used. This includes the contraceptive patch EVRA and the monthly injection Mesigyna which contain both oestrogen and progesterone. In women with a history of severe migraines, the use of these hormones can cause significant disabling headaches and should be avoided.
There are other low-dose pills that can be taken which have less oestrogen than the Minigynon. There are oral contraceptive pills containing 20 and 15 micrograms of oestrogen. The lower the dose of oestrogen, the fewer the side effects. These pills are just as effective in preventing pregnancy and are better tolerated since the symptoms of nausea, vomiting, bloating, and headaches are less common.
Other options to using the Minigynon such as the Depo Provera injection and the intrauterine contraceptive device (IUCD) should also be explored. The Depo Provera injection is given every 90 days. It has no oestrogen in it and typically does not aggravate migraine headaches. It can, however, be associated with irregular uterine bleeding in the first year of usage. Weight gain may also be a problem for some women. However, Depo Provera is a safe long-term option.
The IUCD works well and offers a long-term reversible option. The copper-T IUCD, which lasts for 10 years, or the Mirena, which contains a progesterone (Levonorgestrel), are both effective options. The Mirena lasts for five years and is associated with lighter, painless menstrual periods.
Both the Mirena and the copper-T IUCD can be removed whenever a pregnancy is desired and so do not have to be kept in for the five to 10 years that the methods usually last. A barrier method such as female or male condom can be used in the interim if you are unsure about the other methods. The use of the condom is always a good practice even if you are using another method, since this will help to reduce your risk of sexually transmitted infections in addition to offering you a good option for contraception if it is used properly and regularly. The best advice is to discontinue the Minigynon 30 and consult your family doctor or gynaecologist to obtain further information and guidance about one of the alternatives mentioned.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver. com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax 968-2025. Dr Mitchell cannot provide personal responses.
DISCLAIMER: The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
