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Contraception and migraine with aura — CCFP MCQ

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HardWomen's health/OB/GYNContraception and migraine with auraCCFP

A 31-year-old with migraine with visual aura wants highly effective reversible contraception and lighter periods. She has no pelvic infection and accepts an intrauterine method. What is the best option?

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

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Correct answer: D — Offer a levonorgestrel-releasing intrauterine system after routine eligibility assessment

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

E is correct. A levonorgestrel intrauterine system provides highly effective estrogen-free contraception and typically reduces menstrual bleeding. A, B and C all expose a patient with migraine with aura to estrogen-associated ischemic-stroke risk regardless of route. D falsely excludes intrauterine methods and ignores other progestin-only options. Shared decision-making should also cover insertion, bleeding changes, duration and sexually transmitted infection protection.

Reference: SOGC Canadian Contraception Consensus: Special populations: https://www.jogc.com/article/S1701-2163(15)31045-7/fulltext