Suspected reversible cerebral vasoconstriction syndrome following ethinylestradiol-containing oral contraceptive use in a patient with migraine.

A transgender woman with a history of migraine experienced severe headaches and seizures. This occurred after starting an oestrogen-containing oral contraceptive for gender-affirming therapy. Oestrogen can increase cerebrovascular risks, especially in those with migraines. Initial brain scans showed a possible cortical infarct, indicating a serious issue. After stopping the contraceptive, her symptoms improved completely. The brain imaging also returned to normal. This case highlights the potential risks of using oestrogen in individuals with migraines. It shows how exogenous oestrogen can complicate migraine conditions and cerebrovascular health. More research is needed to understand these risks better. Patients and doctors should carefully consider these factors when choosing treatments. Awareness of these potential complications can help guide safer options for individuals with migraines. Clinical relevance: This case emphasizes the need for caution when prescribing oestrogen to patients with migraines.