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Migraine with aura and CHC — DRCOG MCQ

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ModerateContraception and Sexual HealthMigraine with aura and CHCDRCOG

A 24-year-old woman requests the combined oral contraceptive pill. She has migraine with visual aura twice a year, does not smoke and has blood pressure 112/70 mmHg. What would you advise?

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

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Correct answer: E — Advise against combined hormonal contraception and discuss safer alternatives

Migraine with aura is a contraindication to combined hormonal contraception because of increased ischaemic stroke risk. Age under 35 and normal blood pressure do not remove this contraindication. Neurology review is not needed before offering safer methods such as POP, implant, IUD or IUS. The pearl is that aura status matters more than migraine frequency for UKMEC classification.

Reference: FSRH UKMEC; FSRH Combined Hormonal Contraception guideline