A 22-year-old woman with a history of migraine with aura requests contraception. According to WHO MEC, combined hormonal contraceptives are classified as:

• A Category 1 (no restriction)
• B Category 2 (advantages generally outweigh risks)
• C Category 3 (risks generally outweigh advantages)
• D Category 4 (absolute contraindication) ✓

Explanation

Migraine with aura is a WHO MEC Category 4 (absolute contraindication) for combined hormonal contraceptives at any age, due to significantly increased risk of ischemic stroke. Migraine without aura is Category 2 for women <35 years. Progesterone-only methods and copper IUD are safe alternatives (Category 1-2).

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.