Use continuous low-dose hormonal strategies thoughtfully, balance stroke risk against symptom benefit, and monitor for serotonergic or cardiovascular interactions when newer migraine agents are added.

Menstrual migraine prevention often uses continuous or extended-cycle hormonal contraception; Lower estrogen exposure appears safer from a stroke perspective; Progestin-only options have not shown the same stroke signal as combined pills; Atogepant is a CGRP receptor antagonist used for migraine prevention; Lasmiditan avoids vasoconstriction but requires caution with serotonergic and cardiac interactions