Sex Hormones and Contraceptives

A 28-year-old woman presents with amenorrhea for 6 months after discontinuing oral contraceptive pills (OCPs) containing ethinyl estradiol and levonorgestrel. She denies pregnancy symptoms and has no galactorrhea. Which investigation is most appropriate to rule out post-pill amenorrhea and confirm normal hypothalamic-pituitary-ovarian (HPO) axis function?

A 35-year-old woman on combined oral contraceptive pills (COCPs) for 8 years presents with a 3-month history of breakthrough bleeding and irregular spotting. She is compliant with pill intake and has no signs of infection. Which investigation is most appropriate to exclude a serious underlying pathology and confirm that breakthrough bleeding is due to the contraceptive itself?

A 35-year-old woman with a history of deep vein thrombosis (DVT) 5 years ago (now off anticoagulation) presents requesting contraception. She has no active thrombosis, normal thrombophilia screening, and desires a highly effective, non-hormonal method. Which is the drug of choice for contraception in this patient?

A 28-year-old woman on combined oral contraceptives (containing 30 µg ethinyl estradiol) presents with breakthrough bleeding. Which pharmacological property best distinguishes estrogen-dominant formulations from progestin-dominant formulations in addressing her symptom?

A 28-year-old woman from Delhi presents to the gynecology clinic for contraceptive counseling. She has a history of migraine with aura and occasional visual disturbances. Her blood pressure is 118/76 mmHg, BMI 24 kg/m², and general examination is unremarkable. She is keen to start oral contraceptives but is concerned about her migraines. Which of the following is the most appropriate contraceptive choice for this patient?