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Contraception in migraine without aura — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareContraception in migraine without auraUSMLE Step 3

A 35-year-old woman with migraine without aura asks for contraception. She does not smoke, has normal blood pressure, and has no history of thrombosis. She prefers a highly effective reversible method and wants lighter menses. Which of the following would you recommend at the follow-up visit?

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Correct answer: A — Levonorgestrel intrauterine device

A levonorgestrel intrauterine device is highly effective and can reduce menstrual bleeding. Migraine without aura in a nonsmoker is not a contraindication to progestin-only contraception.

Reference: CDC U.S. Medical Eligibility Criteria for Contraceptive Use