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Adolescent contraception with migraine aura — RACGP Fellowship MCQ

Instant feedback + full explanation. One question, done properly.

HardPreventive health and screeningAdolescent contraception with migraine auraRACGP Fellowship

A 17‑year‑old presents requesting contraception. She has migraine with aura, smokes occasionally, and wants reliable contraception. Her blood pressure is 118/70 mm Hg and a pregnancy test is negative. What would you advise?

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

Reveal the answer and explanation

Correct answer: B — A progestogen‑only or long‑acting reversible contraceptive method is preferable to combined hormonal contraception

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

Answer C is correct. Migraine with aura contraindicates estrogen‑containing contraception due to additive stroke risk; Australian guidance recommends progestogen‑only or non‑hormonal LARC methods as safer, reliable alternatives. Option A is incorrect because estrogen use is contraindicated regardless of age. B is false—contraception is still required. D is inappropriate for ongoing use. E is incorrect—oestrogen patch still contains estrogen and is contraindicated.

Reference: Australian Prescriber: "Update on long‑ and short‑acting contraceptive methods" (2025); RACGP: "Oral hormonal contraception in special circumstances" (2017), https://australianprescriber.tg.org.au/articles/update-on-long-and-short-acting-contraceptive-methods.html