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 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...

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...