Endocrine Pharmacology USMLE Step 1 Practice Question

A 38-year-old woman with a history of migraine with aura and a one pack-per-day smoking history for the past 12 years presents to her gynecologist requesting oral contraception for cycle regulation and pregnancy prevention. She reports her migraines occur approximately twice monthly, each preceded by a 20-minute visual scotoma, and are well-controlled with sumatriptan. Vital signs show BP 128/82 mmHg, HR 78/min, RR 16/min, BMI 26 kg/m². She denies headache today and has no focal neurologic deficits on examination. Recent laboratory workup reveals a normal D-dimer, prothrombin time, and activated partial thromboplastin time. She has no personal or family history of deep vein thrombosis or stroke. Which pharmacotherapy is relatively contraindicated due to increased thromboembolic and ischemic stroke risk in this patient?