You may be surprised to learn how migraine can disrupt family planning and interfere with fertility treatments.
The relationship between hormones and migraine is complicated, to say the least. Women with migraine usually experience changes in their attack frequency and severity through key life stages, including family planning.
Migraine can complicate conversations about family planning and fertility treatments. Hormone fluctuations during menstruation are a common migraine trigger. Hormone fluctuations are an inherent part of fertility treatments. For this reason, some women may avoid fertility treatments for fear of triggering migraine symptoms.
In a recent Headache article, researchers reviewed previous studies on family planning, fertility treatments and migraine. We spoke to one of the study’s authors, Dr. Andrea Harriott, a Headache Medicine specialist in the Department of Neurology at Massachusetts General Hospital and an Assistant Professor of Neurology at Harvard Medical School, about their findings.
How does migraine interfere with family planning and fertility treatments?
Migraine’s Impact on Family Planning
The researchers found that one of the main ways migraine can influence family planning decisions is by negatively impacting relationships. “There’s enough supportive data to suggest that migraine negatively impacts social relationships,” says Dr. Harriott. She points to several studies that explore the specific impact migraine has on relationships, specifically how it can disrupt “intimacy and family planning.”
The Chronic Migraine Epidemiology and Outcomes (CaMEO) study examined the impact of episodic and chronic migraine on family life. Approximately 17% of respondents indicated that headaches contributed to relationship problems. Some respondents reported choosing not to have children or having fewer children. In a different study, 20% of women said they avoid pregnancy because of migraine.
Additionally, certain migraine medications can harm the developing fetus. When family planning, some medications need to be paused, which may delay pregnancy planning. This is just one of the reasons it’s important to start a conversation with your care provider early on in your family planning process.
How Fertility Treatments Can Impact Migraine
Some fertility treatments may affect migraine. For example, in vitro fertilization (IVF) involves hormone fluctuations. “Even though there is a lack of clear clinical evidence linking these changes in circulating hormones to change in migraine attacks, discussing that possibility with patients is really important” Dr. Harriott says.
If you are considering IVF or other fertility treatments, talk to your doctor. Ask them how IVF may affect any of your current migraine treatments and whether you will need to make changes to your migraine management plan. Your doctor will help you understand what, if any, changes to expect when you start IVF. Then they can help you make decisions about whether fertility treatment is right for you.
Cost of Migraine and Fertility Treatment
The researchers raised concerns about treatment costs for both migraine and infertility. Migraine treatment can be expensive. This puts an extra financial burden on people with migraine who want to start a family and need assisted reproductive technologies to help with pregnancy. The financial impact of treating migraine may have an impact on which fertility treatment women choose.
The Correlation Between Endocrine Disorders and Migraine
Associations between migraine and endocrine dysfunction were also found by the researchers. The endocrine system creates hormones and circulates them throughout the body. An endocrine disorder could influence migraine frequency or severity.
One study found that women with endometriosis were more likely to have migraine. A Danish study found that women with polycystic ovarian syndrome (PCOS) have 2.3 times higher likelihood of migraine. Additionally, endocrine disorders increase the chances of infertility.
What should I say to my doctor?
The relationship between migraine, family planning and infertility treatments can be complicated. Sometimes it’s hard to know exactly where to start the conversation with your doctor. You may even be unsure about which specialist to talk to first—should you talk to your headache specialist or your OBGYN?
Often the first step is simply to tell your doctor you’d like to have a conversation.
Opening the Conversation with Your Doctor
Your doctor is there to help you understand your options so you can make the best decision for your health and well-being. When opening the conversation, it’s important to be direct. “I often tell patients to sit down and say to their doctor, ‘I would like to begin to have a conversation about family planning,’” says Dr. Harriott.
Preparing for your visit with your doctor is also an important part of self-advocacy. Dr. Harriott suggests raising specific concerns during your first visit, such as: “‘I would like to do some type of fertility treatment. I wanted to know your thoughts around it and how I would be able to manage my symptoms throughout the course of family planning, pregnancy, delivery and afterwards.’”
Remember, you are your best advocate. You deserve the care you need to treat your migraine. Be sure to start the conversation early in the family planning process, and don’t be afraid to ask your doctor to explain your options.
Connecting Your Healthcare Providers
Connecting your headache specialist with your reproductive specialist is the best way to get everyone on the same page. This way, both healthcare providers will be aware of your conditions. They can also work together to develop the best treatment plan for you.
“I tell patients to insist on a discussion,” says Dr. Harriott. “I often encourage patients to ask, ‘Do you feel comfortable having a discussion with my reproductive endocrinologist’ or ‘Do you feel comfortable integrating your care with my reproductive endocrinologist and having a discussion with them?’”
Migraine interferes with life events, including family planning and fertility treatment. If you are starting to plan a family or thinking about fertility treatment, talk to your doctor first. Be open about your concerns and questions. Be honest about your plans and intentions. Remember, there are resources available that can help you with migraine, family planning and fertility treatment—or even all three.
To read the full study, click here.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
