A 38-year-old woman with a 15-year smoking history (1 pack daily) and migraine with aura presents requesting oral contraception. She reports migraines occurring twice monthly, each accompanied by unilateral visual scotoma lasting 20 minutes before headache onset. Vital signs: BP 128/82 mmHg, HR 78/min, RR 14/min. Neurological examination is nonfocal. Recent brain MRI was normal. Fasting lipid panel shows LDL 142 mg/dL. She takes only occasional ibuprofen 400 mg as needed. Which of the following estrogen-containing oral contraceptives is relatively contraindicated due to increased thromboembolic and ischemic stroke risk?
- A)Clomiphene
- B)Combined oral contraceptive pillGABARITO
- C)Mifepristone
- D)Finasteride
- E)Cabergoline
Explicação
Combined oral contraceptives increase thromboembolic risk, and that risk becomes especially concerning in smokers older than 35 years and in patients with migraine with aura. This patient therefore has important contraindications to an estrogen containing cont... Ver explicação completa e trilha adaptativa →