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Migraine affects about one third of women of reproductive age; of these, about 20% have migraine with aura (MA). Combination oral contraceptives (COCs) raise risk for ischemic stroke in women with MA; COC use also might be associated with worsening of headache frequency and intensity (JW Womens Health Mar 25 2010). Thus, the CDC recommends progestin-only or intrauterine contraception for such women (MMWR Recomm Rep 2010; 59:1). In a prospective diary-based 9-month pilot study that involved 30 women with MA who sought contraception, Italian researchers evaluated the effects of a progestin-only contraceptive pill (75-µg desogestrel daily) on headache course. Fifteen women had used COCs but had sought alternative hormonal contraception when MA…