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Apr 23, 2018

Experts Shed Light on Stroke Risk and Birth Control Pills

Evidence suggests newer forms of birth control are generally safe, except for women with existing risk factors for stroke. 

The birth control pill doesn’t carry the same health risks that it used to, based on a recent review about the risk of stroke with oral contraceptive pills.

Published in the American Heart Association journal Stroke, this paper reviewed the latest evidence about complications from birth control pills. It was written in response to concerns about increased stroke risk from oral contraceptive pills, which was first noted in the 1970s.

The good news, according to authors, is that newer types of birth control appear much safer than those from past decades.

When birth control pills were first available, they contained progestin only, which caused few side effects but were not as effective as today’s medications. To improve their efficacy, birth control pills began to contain high doses of both estrogen and progestin, which proved more useful in preventing unintended pregnancies.

But with this change also came higher risks. A review of 16 studies from 1960–1999 found these high-dose combination pills were associated with a nearly three-fold increase in stroke risk in women. Many women were concerned about increased heart risks, opting to change their form of birth control or stop use altogether.

Fortunately, times have changed and birth control pills no longer contain the high doses of estrogen and progestin that they used to. A recent study from 1995–2009 found that the newer formulations of birth control have no impact on stroke risk. This study measured the health effects of the birth control pill as well as the birth control patch and vaginal ring.

Research has also shown that progestin-only pills have no impact on stroke risk in healthy women, which is also encouraging.

These findings have helped ease fears about birth control and stroke risk. However, it doesn’t mean that the pill is safe for everyone.

As authors explain, even minor risks associated with the pill could add to existing risk factors for stroke. For example, women who smoke or have high blood pressure already face increased risk for stroke and the pill can increase risk of complications. Research also suggests that the pill may increase stroke risk in women with migraines, especially migraines with an aura.

The take-home message, according to authors, is that newer formulations of the pill are relatively safe, except in women with increased risk for stroke. Thus, it’s important that women—especially those at increased risk for stroke—discuss the benefits and risks of birth control with their doctor to help make the best possible decision for them.

Questions for You to Consider

  • What is stroke?

  • Stroke occurs when there is an interruption of the blood supply to the brain. The two types of stroke include ischemic stroke, where the blood supply to the brain is blocked by a blood clot, and hemorrhagic stroke, which occurs when blood vessels rupture and leak blood into the brain. Symptoms of both types of stroke include sudden numbness in the face, arm or leg, confusion, trouble speaking or understanding, trouble with vision, loss of balance or coordination, and severe headache with no known cause. It is crucial that you call 911 immediately upon experiencing any of these symptoms.
  • How can I help prevent stroke?

  • There are many things adults can do to help prevent a stroke. First, maintain a healthy blood pressure. If you have high blood pressure, visit your physician to properly treat this condition. Maintaining a healthy diet, weight, exercising regularly, limiting alcohol intake, and quitting smoking (if you are a smoker) can also help significantly lower risk for stroke.

Infographic: Stroke


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