A 32-year-old woman requests contraception. She has menstrual migraine with visual aura. She is a non-smoker with no other cardiovascular risk factors. The most appropriate contraceptive option for her is:

• A Progestogen-only pill ✓
• B Combined oral contraceptive pill containing ethinylestradiol and levonorgestrel
• C Combined contraceptive patch
• D Combined contraceptive vaginal ring

Explanation

Migraine with aura is a WHO Medical Eligibility Criteria category 4 condition for combined estrogen-containing methods because estrogen increases stroke risk in these women. Progestogen-only methods carry no such restriction and are category 1 or 2 for aura. The patch and ring deliver systemic estrogen exactly like the pill, so they are equally contraindicated.

Reference: WHO Medical Eligibility Criteria for Contraceptive Use, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.