Birth control pills increase risk of ischemic stroke

March 05, 2018

MAYWOOD, IL - Oral contraceptives increase the risk of ischemic stroke, but this risk is very small among women who do not have other stroke risk factors, according to a Jan. 3, 2018 paper in the journal MedLink Neurology by Loyola Medicine stroke specialists.

Birth control pills do not increase the risk of hemorrhagic strokes, wrote neurologists Sarkis Morales-Vidal, MD, and José Biller, MD. Ischemic strokes, which account for about 85 percent of all strokes, are caused by blood clots.

Hemorrhagic strokes are caused by bleeding in the brain.

Several mechanisms have been proposed to explain why oral contraceptives increase stroke risk, including by raising blood pressure and by making blood hypercoagulable (more likely to clot).

When prescribing hormonal contraceptives, physicians should consider the type and dose of estrogen or progestin and route of administration (such as pill or patch). "The ideal drug is one with the lowest estrogen and progestin doses that will be effective in preventing pregnancy while minimizing adverse effects," Drs. Morales and Biller wrote.

For healthy young women without any stroke risk factors, the stroke risk associated with oral contraceptives is very small.

"However, in women with other stroke risk factors, the risk seems higher and, in most cases, oral contraceptive use should be discouraged," Drs. Morales and Biller wrote. These risk factors include high blood pressure, cigarette smoking and migraine headaches, especially migraines with sensory disturbances called aura (such as flashes of light and tingling in the hands or face).

However, women may not always be adequately screened. One previous study found that, among women with one or more stroke risk factors, only 15 percent recalled being advised not to start oral contraceptives and only 36 percent remembered being told to stop. Fifteen percent of women were still taking oral contraceptives despite being told to discontinue. These findings highlight the need to improve physician counseling and patient compliance, Drs. Morales and Biller wrote.
-end-
Their report is titled "Hormonal Contraception and Stroke." It is an update of a report originally published in Medlink Neurology in 2003.

Dr. Morales is an associate professor and Dr. Biller is a professor and chair of the department of neurology of Loyola University Chicago Stritch School of Medicine.

Loyola University Health System

Related Ischemic Stroke Articles from Brightsurf:

Amniotic fluid may yield new, better treatment for ischemic stroke
A study released in STEM CELLS Translational Medicine points the way to a possible new avenue of treatment for ischemic stroke.

Risk of ischemic stroke in patients with COVID-19 compared with influenza
This observational study compares the rate of ischemic stroke among patients with COVID-19 compared with influenza in two New York hospitals.

Research shows COVID-19 is an independent risk factor for acute ischemic stroke
COVID-19 infection is significantly associated with strokes, and patients with COVID-19 should undergo more aggressive monitoring for stroke.

Ischemic stroke rates decrease during COVID-19 pandemic
Research reveals fewer people have been admitted to stroke centers in Michigan and northwest Ohio since the onslaught of the COVID-19 pandemic, and significantly fewer patients received a mechanical thrombectomy for their ischemic stroke.

Antioxidant treatment in acute ischemic stroke may delay the onset of Alzheimer's dementia
There is a considerable overlap between vascular risk factors and risk factors of Alzheimer's disease (AD).

AJR: Smartphone, laptop prove reliable and accurate for acute ischemic stroke decision
A unique assessment of imaging-based recommendations for the administration of IV recombinant tissue plasminogen activator based on unenhanced brain CT scans, the results published ahead-of-print in this April article from the American Journal of Roentgenology (AJR) constitute a strong foundation for the development of mobile-based telestroke services because they increase neuroradiologist availability and the possibility of using reperfusion therapies in resource-limited countries.

Stable ischemic heart disease in the older adult
In the current issue of Cardiovascular Innovations and Applications, Juan R.

Diabetes mellitus and stable ischemic heart disease
In the current issue of Cardiovascular Innovations and Applications, Cody Schwartz and David Winchester from the Malcom Randall VAMC, Gainesville, Fla., USA consider diabetes mellitus and stable ischemic heart disease.

Contemporary management of patients with stable ischemic heart disease
In the current issue of Cardiovascular Innovations and Applications, Radmila Lyubarova, Joshua Schulman-Marcus and William E.

Epidemiology, pathophysiology, and therapeutic targets in stable ischemic heart disease
In the current issue of Cardiovascular Innovations and Applications, C.

Read More: Ischemic Stroke News and Ischemic Stroke Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.