Contraception and migraines with aura

[FMFL]

Can anyone tell me if I would be able to ask the Dr to prescribe me the combined pill if I have a history of migraine with aura? I cannot take the mini-pill as it messed up my periods and I bled every day...effective contraception in itself. I have heavy periods and so do not want the copper coil. I really don’t want to take anything that may make periods worse! I gather that the combination pill is not recommended for migraine with aura sufferers but can it be prescribed nevertheless? The increased risk of stroke is small. I’m not overweight and nor do I smoke.

You can ask, but migraine with aura is Ukmec 4 "a condition which presents an unacceptable health risk if the method is used". The full guideline is on the FSRH website.

If you already have heavy periods, a Mirena coil might be an option?

dale ah, ok thanks, highly unlikely to be prescribed in that case. I was a bit worried about the Mirena coil in case I had the constant breakthrough bleed I had with the mini-pill.

As with any of these things there is an element of suck it and see, though Mirena is pretty reliable at stopping bleeding altogether (can take a few months to settle down). Might be worth a conversation!