Migraine

E.G. has past medical history of migraines. Further information is needed to assess pattern, frequency, duration, severity and triggers of such migraines and treatments. Migraine is a genetically influenced complex disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea and increased sensitivity to light and sound. As migraines are more frequent among females, a variety of hormones have been implicated in their pathogenesis; specifically, prior research has repeatedly shown evidence linking estrogen to migraine headaches.

E.G is a 38Y/o W, F  G5, P5 0 0 6, who presents to the clinic to “discuss contraceptive options”.  E.G is in a new relationship with her boyfriend and although he has never fathered a child, E.G states that she is not interested in having more children. Important considerations to discuss with E.G and her boyfriend are if the agree to birth control and if so, to what method; ie; barrier methods, short acting hormonal, long-acting hormonal, sterilization. Birth control methods are designed to prevent conception or interrupt or nullify implantation and growth. Conception can be prevented by hormonally disrupting the menstrual cycle (Oral contraceptive (OC) pills), by physically blocking the passageway (barrier methods or sterilization), or less successfully, by abstinence during fertile periods or withdrawal method. Implantation is impaired via the use of a foreign body (intrauterine device {IUD}) or surgical removal (Salpingectomy or Vasectomy). In addition, E.G. does not have any recent medical work up on file, so we will begin by obtaining pertinent medical history and information such as LMP? Menstruation history? Prior methods of contraception? Obtain a urine HCG, pelvic examination including pap smear, and STI screening for baseline studies. In addition, upon clinical breast examination, E.G has fibrocystic changes bilaterally and will need further information regarding any symptoms she may be experiencing and continued monitoring and assessments. E.G has 1st degree cystocele and further information is needed to assess for symptoms and possible need for imaging versus monitoring.