American Board of Internal Medicine (ABIM) Certification Practice Exam

The recommendation for using an intrauterine device (IUD) for women with a history of migraines preceded by visual aura is based on the concerns related to estrogen-containing contraceptive methods. Migraine with aura is associated with an increased risk of stroke, and for this reason, the use of combined oral contraceptives, which contain estrogen, is generally contraindicated in these patients.

IUDs, on the other hand, do not contain hormones and therefore eliminate the risks associated with estrogen. They provide effective contraception without the potential cardiovascular risks that can accompany estrogen-containing methods. Additionally, IUDs can be especially beneficial for women who may experience other contraindications to hormonal contraceptives or who prefer a long-term solution that does not require daily attention.

In summary, the IUD is a suitable choice for preventing pregnancy in women with a history of migraines with aura because it avoids the risks related to hormonal contraceptives, aligning with safety guidelines in the management of these patients.