Question

A 30-year-old woman presents with episodic unilateral throbbing headaches with photophobia and nausea, diagnosed as migraine with aura. She smokes and has no other major conditions. She requests a combined oral contraceptive pill. According to Australian contraceptive guidance, what is the most appropriate advice?

Accepted Answer

Combined oral contraceptives are contraindicated because of increased stroke risk in migraine with aura; offer a progestogen-only or non-hormonal method

Answer

Combined oral contraceptives are safe in all women under 35 years

Answer

Advise starting a high-oestrogen combined pill to stabilise hormones

Answer

Recommend no contraception because pregnancy will improve migraine

Answer

Recommend combined oral contraception only if she stops smoking, with no other considerations

Practice question