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What strategies do you recommend for discussing the use of OCP in women with a history of migraines with or without aura?
In light of publication from Ihara et al in Cephalagia 2025 Dec
Answer from: at Community Practice
The Centers for Disease Control's Medical Eligibility Criteria (MEC) considers migraine with aura to be a contraindication to the use of combined oral contraceptives (COCs) due to the increased risk of ischemic stroke. This is based upon limited, mostly older, studies that demonstrated some increase...
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Answer from: at Community Practice
In light of the recent publication from 2025 publication by Ihara et al. in Cephalagia, modern low-dose combined hormonal contraceptives (CHCs) do not appear to add vascular risk in otherwise healthy young women with migraine. Migraine with aura remains an important marker of vascular risk regardles...