Why OCP r contraindicated in migraine with aura?? How Prolactinoma cause insulin resistance??

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Oral contraceptive pill is associated with small risk of stroke,it is independent risk factor for young stroke.The risk increases with OCP taken by women who ha ve additional risk of migraine with aura. In other words to prevent the risk vascular insult of brain OCPr contraindicated in migraine with aura. Experimental studies indicate that high prolactin level has effect on food intake,body wt and insulin resistance by inhibiting adiponectin and IL - 6 production in adipose tissue which may lead to type 2 DM.
Ma'am could u plz help regarding how migraine with aura predisposes to stroke?? The mechanism behind this if possible??
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Migraine is due to cranial vascular spasm . Migraine with aura may be due involvement of intracranial arteries. Estrogen in OCP increases chances thromboembolism Hence OCP can be potentially hazardous in migraine . Prolactin increases B cell proliferation in islet cells, and increases insulin secretion. There is resultant change in Free Fatty Acids and down regulation of insulin receptors in cell causing insulin resistance. This may cause metabolic syndrome .
Thank you doctor
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Women suffering from migraine with aura (MA), menstrually related migraine or pure menstrual migraine constitute a group of patients at higher risk of worsening during COC use. Low-dose COCs confer a twofold increase in ischemic stroke (IS) risk. This risk increases if hypertension or smoking are associated.
Could u plz elaborate? Couldn't understand
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OCP or combined pill is associated with a small increase risk of ischemic stroke therefore ocp are contraindicated in migraine with aura. Prolactinoma causes hyperprolactinemia , has been associated with impaired metabolism , inducing glucose intolerance. This causes insulin resistance
Thank you doctor
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As cocp contains estrogen with a chance of mild stroke As well cop lead to water retention leading to increase in migraine. Pop have no such effect so it can be given.
Ocp contra During menstruation migraine plus ocp increased frequency of attack so not use

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