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A 19-year-old woman had a Mirena® intrauterine system (IUS) fitted for contraception 10 weeks postnatally. She attended our clinic 4 weeks later and reported apparent migraine with aura, which had developed within a few days of the fitting. Initially, she tried paracetamol and ibuprofen, which were not helpful, and saw her general practitioner who prescribed a triptan. The headaches were becoming increasingly severe, and she requested removal of the IUS.
She had no pelvic pain and no vaginal bleeding apart from slight spotting after the IUS insertion. She was a non-smoker with no personal risk factors for vascular disease and no family history of vascular disease. She was not taking any prescribed …