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Migraine with aura — DFSRH MCQ

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ModerateCombined hormonal contraceptionMigraine with auraDFSRH

A 28-year-old woman requests the combined pill. She has focal visual symptoms followed by throbbing headache twice each year and is otherwise well. What is the UKMEC category for combined hormonal contraception?

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Correct answer: C — UKMEC 4

Migraine with aura is UKMEC 4 for CHC because of the arterial thrombotic risk. A lower oestrogen dose does not remove this contraindication. The key discriminator is aura, not the frequency of headache.

Reference: FSRH Combined Hormonal Contraception Guideline; UKMEC 2025; BNF