Progestin-only pills are safe in patients who have migraines with aura.

• A. Not studied
• B. False
• C. Only with aspirin
• D. True

Answer: (D)

Migraines with aura are a scenario where estrogen-containing contraception raises the risk of ischemic stroke, so avoiding estrogen is important. Progestin-only pills do not contain estrogen, so they do not add that same stroke risk. That makes them a safer contraceptive option for patients with migraines with aura. They are effective when taken consistently every day, though they can cause irregular bleeding or other progestin-related effects. Because of this, progestin-only methods are often recommended as an alternative to combined hormonal methods for people who have migraines with aura. So the statement that progestin-only pills are safe in patients with migraines with aura is true.