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Contraception with migraine with aura — USMLE Step 3 MCQ

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ModerateOB/GYN (prenatal care, contraception, screening)Contraception with migraine with auraUSMLE Step 3

A 22-year-old woman requests contraception. She has migraine with aura and smokes 10 cigarettes daily. She wants a highly effective reversible method. Pregnancy test is negative. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Offer a levonorgestrel intrauterine device

Estrogen-containing contraception is avoided in migraine with aura; progestin IUDs are highly effective and appropriate for many patients.

Reference: CDC U.S. Medical Eligibility Criteria for Contraceptive Use; ACOG contraception guidance