The pill
In some women, birth control pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe. But in other women, the pills may worsen their migraines. In still other women, taking birth control pills has no effect.

The reason for these different responses is not well understood.  For women whose migraines get worse when they take birth control pills, their attacks seem to occur during the last week of the cycle. This is because the last seven pills in most monthly pill packs don’t have hormones; they are there to keep you in the habit of taking your birth control daily. Without the hormones, your body's estrogen levels drop sharply. This may trigger migraine in some women.

Talk with your doctor if you think birth control pills are making your migraines worse. Switching to a pill pack in which all the pills for the entire month contain hormones and using that for three months in a row can improve headaches. Lifestyle changes, such as getting on a regular sleep pattern and eating healthy foods, can help too.

The stress factor
Stress can trigger both migraine and tension-type headache. Events like getting married, moving to a new home, or having a baby can cause stress. But studies show that everyday stresses—not major life changes—cause most headaches. Juggling many roles, such as being a mother and wife, having a career, and financial pressures, can be daily stresses for women.

Making time for yourself and finding healthy ways to deal with stress are important. Some things you can do to help prevent or reduce stress include:

    * eating healthy foods
    * being active (at least 30 minutes most days of the week is best)
    * doing relaxation exercises
    * getting enough sleep

Try to figure out what causes you to feel stressed. You may be able to cut out some of these stressors. For example, if driving to work is stressful, try taking the bus or subway. You can take this time to read or listen to music, rather than deal with traffic. For stressors you can't avoid, keeping organized and doing as much as you can ahead of time will help you to feel in control.

Types of migraine

The two forms seen most often are migraine with aura (previously called classical migraine) and migraine without aura (previously called common migraine).

With a migraine with aura, a person might have these sensory symptoms (the so-called "aura") 10 to 30 minutes before an attack:

    * seeing flashing lights, zigzag lines, or blind spots
    * numbness; or tingling in the face or hands
    * disturbed sense of smell, taste, or touch
    * feeling mentally "fuzzy"

Only one in five people who get migraine experience an aura. Women have this form of migraine less often than men.

With migraine without aura, a person does not have an aura but has all the other features of an attack.

Migraine vs. tension-type headache

Compared with migraine, tension-type headache is generally less severe and rarely disabling. Compare your symptoms with those in this chart to see what type of headache you might be having.

Note: Rebound headache may have features of tension and/or migraine headache

Adapted from a table produced by the American Council for Headache Education

Although fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by factors listed above.

There also are differences in how types of headaches respond to treatment with medicines. Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.

You can't tell the difference between a migraine and a tension-type headache by how often they occur. Both can occur at irregular intervals. Also, in rare cases, both can occur daily or almost daily.