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Contraception with Migraine Aura — MRCGP AKT MCQ

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HardObstetrics & GynaecologyContraception with Migraine AuraMRCGP AKTUKMLAPARA

A 27-year-old with migraine with aura requests reliable contraception and has no other medical condition. Which option is medically eligible?

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Correct answer: D — Oral progestogen contraceptive method

The best answer is “Oral progestogen contraceptive method”. Migraine with aura makes combined hormonal contraception an unacceptable stroke risk regardless of delivery route or oestrogen dose. Progestogen-only and non-hormonal methods can be used after individual counselling; aspirin does not neutralise the oestrogen-associated risk. The alternatives can be reasonable in related presentations, but they require a different severity, eligibility criterion, treatment setting or clinical objective from the one described.

Reference: FSRH: UK Medical Eligibility Criteria for contraceptive use: https://www.fsrh.org/standards-and-guidance/fsrh-guideline-ukmec/