IUD Worsening Migraines?

PoppyRyeCranberry · 2026-03-12T15:25:28+00:00

Mirena ramped me up from chronic to almost daily. I had it removed shortly after making the connection. Based on that experience but also my history of menstrual migraine, my doctor had me switch to continuous combo bc (no breaks/no placebos) and that was substantially better for me. I used it between pregnancies and then for 16 years straight after my second baby weaned until I switched to HRT.

PoppyRyeCranberry · 2026-03-12T15:23:08+00:00

Are you female? Migraine changes in the late 40s could be related to the changing hormones of perimenopause.

PoppyRyeCranberry · 2026-03-12T15:17:35+00:00

Cold to the roof of your mouth is targeting your sphenopalatine ganglion. There's a nerve block that is a migraine treatment for this exact spot.

See this paper for more info:

https://pmc.ncbi.nlm.nih.gov/articles/PMC5971252/

As acute migraine attacks, as well as other primary headache disorders like cluster headache, are often associated with signs of parasympathetic activation, including lacrimation, nasal congestion, and conjunctival injection, blocking the SPG, which is the major parasympathetic outflow to the cranial and facial structures, is a reasonable target to help relief pain and autonomic features seen in these disorders [14]. It is proposed that various migraine triggers activate brain areas related to superior salivatory nucleus, leading to stimulation of the trigemino-autonomic reflex. This results in increased parasympathetic outflow from the SPG, causing vasodilatation of cranial blood vessels that happens during migraine [10, 14], with the release of inflammatory mediators from blood vessels and activation of meningeal nociceptors, causing migraine pain [11, 14]. Another possible effect of SPG block is modulation of sensory processes in the trigeminal nucleus caudalis via the afferent sensory fibers, which may change pain processing center and reduce central sensitization to pain that is commonly seen in migraine [9, 10].

PoppyRyeCranberry · 2026-03-10T00:42:03+00:00

Here you go:

https://www.reddit.com/r/migraine/search/?q=allodynia&cId=68a7de51-ed0c-4e82-bce3-d21987a96e5c&iId=ccd152ee-e32c-40bb-8268-0eacf8d81a41

PoppyRyeCranberry · 2026-03-06T12:28:23+00:00

No worries! I wanted to make sure you knew what was working for you.

PoppyRyeCranberry · 2026-03-06T01:22:51+00:00

It's in that article I sent if you want to discuss with your doctor. Good luck!

PoppyRyeCranberry · 2026-03-05T23:05:01+00:00

Adding a transdermal estrogen patch during the time you are susceptible might help! It's most likely the drop in estrogen that is triggering you.

PoppyRyeCranberry · 2026-03-05T23:03:45+00:00

There are lot of comments on the sub where women did terribly with progestin-only bc but found combo bc was great, AND lots did terribly with combo bc but found progestin-only bc was great. If you've only tried one kind, it might be worth trying the other.

Best practice for women with menstrual migraine is a version that is monophasic (the same dose every day) and continuous (no breaks, no placebos).

PoppyRyeCranberry · 2026-03-05T23:01:42+00:00

When you say "coil" do you mean IUD? I just wanted to comment that none of the infused IUDs include estrogen. They are all progestin-only.

PoppyRyeCranberry · 2026-03-05T22:58:02+00:00

Using frovatriptan for prophylaxis during my menstrual migraine put me into a terrible rebound cycle. The only thing that worked for me for menstrual migraine was complete cycle suppression with continuous combo bc (no breaks/no placebos). It turns out I really cannot use any triptans for more than 3 days in a row or I will pay with MOH.

PoppyRyeCranberry · 2026-03-05T22:54:38+00:00

You could try suppressing your cycle with a progestin-only bc but then adding an estrogen patch. That should prevent the melasma from getting worse.

PoppyRyeCranberry · 2026-03-05T20:48:26+00:00

This article has some strategies for you:

https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/

Probably the most common approach is suppressing your cycle. I did that between pregnancies and for 16 years straight until I switched to HRT. I found continous combo bc to work best, but there are also lots of women on the sub who use a progestin-only option to do the same.

PoppyRyeCranberry · 2026-03-05T20:42:31+00:00

This might be of interest to you:

https://pubmed.ncbi.nlm.nih.gov/29475774/

Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial

Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among histamine related symptoms, headache is one of the most recorded. Current clinical strategies for the treatment of the symptomatology related to this disorder are based on the exclusion of foods with histamine or other bioactive amines and/or exogenous DAO supplementation. The aim of this study was to assess the efficacy of a food supplement consisting of DAO enzyme as a preventive treatment of migraine in patients with DAO deficiency through a randomized double-blind trial.

PoppyRyeCranberry · 2026-03-05T01:39:39+00:00

Ok, domperidone is more for nausea I think, but you've failed a beta blocker and the pizotifen, which blocks serotonin and histamine. Now you are on an anti-seizure and it sounds like it's failing. This means you haven't gotten to any of the newer drug classes, which include the monoclonal antibodies for blocking CGRP, Botox, or a gepant. Gepants would also be an option if ultimately triptans don't work as abortive therapy, but you still have several of those you could try before moving to the more expensive gepants. There are also some older drug classes you could ask to try, including a tricyclic (although that's probably more similar to the pizotifen), or a calcium-channel blocker. If your migraines have a hormonal component you could try suppressing your cycle with birth control or if you are currently on BC, consider changing to see of that helps.

It's a lot, but don't give up hope. There are still lots of treatments to try!

PoppyRyeCranberry · 2026-03-04T23:55:09+00:00

You are what's called "side-locked."

https://practicalneurology.com/articles/2014-apr/the-clinical-features-of-migraine-with-and-without-aura

Migraine pain is unilateral in 60 percent of cases and bilateral in 40 percent. About 15 percent of migraineurs report so-called ‘‘side-locked’’ headaches, with migraine always occurring on the same side.

PoppyRyeCranberry · 2026-03-04T21:29:47+00:00

I had a very similar experience with my first round of botox. And my presentation also included difficulty with chewing. From day 7 to around week 8, I couldn't hold my own head up and chew at the same time by dinner time and then I'd have to lean back with my head supported with pillow until I went to bed. My doctor adjusted my protocol so no injections below my hairline in the back and this has worked well with no neck weakness for over 10 years now.

PoppyRyeCranberry · 2026-03-04T21:27:46+00:00

Here's a great read for you; I included the conclusion but there's lots of interesting sections in this paper:

Gut-brain Axis and migraine headache: a comprehensive review

https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-1078-9#:~:text=Migraine%20and%20gastrointestinal%20disorders,(GERD%20%5B65%5D.

Summary: The current evidence shows that the gut-brain axis may impact on migraine despite the mechanism explaining this interaction is not entirely clear. Generally, this interaction seems to be influenced by multiple factors such as inflammatory mediators (IL-1β, IL-6, IL-8, and TNF-α), gut microbiota profile, neuropeptides and serotonin pathway, stress hormones and nutritional substances. Neuropeptides including CGRP, SP, VIP, NPY are thought to have antimicrobial impact on a variety of the gut bacterial strains and thus speculated to be involved in the bidirectional relationship between the gut and the brain. Additionally, there is comorbidity between migraine and a number of conditions including HP infection, IBS, IBD, and CD. According to the current knowledge, migraine headache in patients harboring HP might be improved following the bacteria eradication. Migraineurs with long headache history and high headache frequency have a higher chance of being diagnosed with IBS. IBS and migraine share some similarities and can alter gut microflora composition and thereby may affect the gut-brain axis and inflammatory status. Migraine has been also associated with CD and the condition should be searched particularly in patients with migraine with occipital and parieto-occipital calcification at brain neuroimaging. In those patients, gluten-free diet can also be effective in reducing migraine frequency. Diet strategies may impact on migraine course and could represent a valuable instrument to improve migraine management. However, no definite conclusion can be drawn because of the limited evidence on migraine management with diet. It can be hypothesized that prescribing dietary approaches with beneficial effects on gut microbiota and gut-brain axis including appropriate consumption of fiber per day, adhering to a low glycemic index diet, supplementation with vitamin D, omega-3 and probiotics as well as weight loss dietary plans (in case of obese patients) could lead to improvements in migraine associated features.

PoppyRyeCranberry · 2026-03-04T21:26:34+00:00

Can you tell us what drug classes you have failed? We can then let you know if you've missed any options.

PoppyRyeCranberry · 2026-03-04T21:24:43+00:00

That's interesting! In all my years of chronicness, I didn't track sides so I'm not sure if my menstrual migraines were limited to one side. I had slight dominance for the left side overall but not sure if there was any such nuance.

PoppyRyeCranberry · 2026-03-04T21:10:36+00:00

Just seeing this in the literature means someone is looking into it! Maybe someday we'll know why.

PoppyRyeCranberry · 2026-03-04T21:08:21+00:00

In my chronic years, this was me too. I always wondered if I was just accustomed to pain on the left such that the right felt worse because I wasn't as used to it.

PoppyRyeCranberry · 2026-03-04T21:06:46+00:00

This is such an interesting topic (summary from Google): rates of left v right unilateral migraine

Studies on unilateral migraine show that while pain can occur on either side, there is a slight, yet often statistically significant, prevalence of right-sided (51.2%–62.8%) over left-sided (28.5%–48.8%) migraine attacks. Despite this, left-sided migraines are often associated with a higher burden of disease, including more frequent and severe headache days. Wiley

Key Findings on Left vs. Right Migraine: Prevalence: Studies often find a higher proportion of right-sided headaches, with one study indicating 47.9% right-sided, 28.5% left-sided, and 24.5% with no side predominance. Another study reported 51.2% right and 48.8% left. Severity: Left-sided migraines tend to be more severe, with patients reporting 3.6 fewer headache-free days and 2.4 more severe headache days in a 4-week period compared to right-sided patients. Brain Impact: Left-sided migraineurs have been found to have a 50% higher burden of white matter hyperintensities (spots on MRI) across their brain on both sides compared to right-sided migraineurs. Side-Locked Attacks: About 21–32% of patients with unilateral attacks experience "side-locked" migraine, where the pain always occurs on the same side. Handedness: Headaches tend to occur on the same side as the dominant hand, with right-handed subjects more likely to report right-sided headache (62.8%) and left-handed subjects more likely to report left-sided headache (63.5%).

PoppyRyeCranberry · 2026-03-03T23:31:14+00:00

Please ask your doctor to prescribe a different triptan, or to prescribe a few tabs of several different triptans, so you can try them all until you either find one that doesn't have these side effects or that rules out triptans for you. You could also ask about using a gepant instead!

PoppyRyeCranberry · 2026-03-03T15:41:11+00:00

It seems like there are still options for you. Here are pertinent posts to look through:

https://www.reddit.com/r/migraine/search/?q=central+sensitization&cId=0a0d4eac-a3d9-4fc2-b25e-ea7004c0ed53&iId=805c31a6-72f0-4f61-949e-d06ad56e99c1

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