Oral contraceptives increase the risk of ischemic stroke

Medical Network March 8th According to a recent study by Loyola Medicine stroke experts and published in MedLink Neurology, oral contraceptives increase the risk of ischemic stroke, but no other risk of stroke women The risks are particularly small.

Contraceptives do not increase the risk of hemorrhagic stroke, says neuroscientists Dr. Sarkis Morales-Vidal and Dr. José Biller. Ischemic stroke accounts for 85% of the stroke and is caused by blood plaques.

Hemorrhagic stroke is caused by cerebral hemorrhage.

There are several mechanisms that may explain why oral contraceptives increase the risk of stroke, including raising blood pressure and keeping the blood in a hypercoagulable state.

When a doctor prescribes a hormonal contraceptive, the doctor should consider the type and dose of estrogen and progesterone, as well as the route of administration (pill or patch). "The ideal drug is a low level of estrogen and progesterone, while preventing pregnancy and minimizing side effects," Dr. Morales and Dr. Biller wrote.

For healthy young women who do not have any other risk of stroke, the risk of stroke associated with oral contraceptives is very small.

“But for women at risk of other strokes, this risk seems to be higher, and in most cases, they should be discouraged from using oral contraceptives,” Morales and Biller wrote. These risk factors include high blood pressure , smoking, migraine, and especially migraine with a precursor to cognitive impairment.

But women are not always strictly screened and followed. A previous study found that only 15% of women with one or more stroke risk factors remember being advised not to start using oral contraceptives, while only 36% remember being told to stop using contraceptives. Despite being told to stop the birth control pill, 15% of women continue to use oral contraceptives. These findings underscore the need to improve physician counseling and patient compliance.

The study, called "Hormonal Contraception and Stroke," is an update to a study published in MedLink Neurology in 2003.