Birth Control Pills and Stroke

Birth control pills and stroke

Oral contraceptives have been around for years and have given women substantial reproductive freedom. Overall, they are safe, and newer formulations are even safer and easier to use than in the past. But, there is an elevated risk of blood clots with the use of oral contraceptives. Many women wonder how significant those risks are and if the risk of stroke while using birth control pills is enough reason to avoid them.

Stroke safety is an especially important question for teenagers making a decision about whether to use oral contraceptives, because teenagers are less likely to recognize the symptoms of a stroke or a TIA.

Hundreds of thousands of women have used birth control pills over the years, so there are real answers to questions about oral contraceptives and stroke. 


Birth control and stroke risk

Overall, women who take birth control pills have approximately a 50%-100% higher risk of stroke compared to women who do not use birth control pills. While that sounds like a huge increase in stroke risk, it is not actually a high number of strokes. That is because the vast majority of young women who do not use birth control pills do not experience strokes or any kind of blood clots, so a 50% higher risk is still quite low.

Most women who use birth control pills are under the age of 35-40, as women over that age generally rely on more long-lasting means of birth control.

So, with a population of relatively young women taking oral contraceptives, strokes are quite rare, even with the relative increase in stroke risk associated with oral contraceptives.


Birth control formulations and stroke risk

Studies that show an increased risk of stroke with oral contraceptives consistently note that oral contraceptives containing a higher dose of estrogen are the ones most strongly associated with stroke.

Authors of one of the largest research studies on the subject recommended oral contraceptives formulated with less than 50ug estrogen to prevent stroke.  

Most significantly, women with certain health conditions constitute the vast majority of strokes related to use of oral contraceptives.


Which health conditions are associated with birth control pill linked stroke?

Women who are smokers or who already have been diagnosed with blood-clotting disorders are the most likely experience a stroke while taking birth control pills. Some other conditions associated with a higher tendency to blood clots and strokes while taking oral contraceptives include polycyclic ovary syndrome and hypertension. 

Several research studies suggest that women who suffer from migraine with aura are also more inclined to an elevated chance of stroke with birth control pills. Migraine with aura is a type of migraine headache accompanied by neurological symptoms such as vision loss, tingling or weakness.


Is it safe for teenagers to use birth control pills?

Overall, teenagers are not at higher risk of birth control pill related stroke than women who are in their 20's or 30's.

This means that, while there is a slight risk of stroke while using birth control pills, the likelihood of becoming pregnant if you are sexually active and not taking birth control far outweighs the risk of a stroke with birth control pills.

Studies show that teenagers are often unaware of the risk of stroke or of the side effects of birth control pills, in general. If you are a teenager taking birth control polls, you should learn how to recognize the symptoms of a stroke, and you should stay responsible by protecting yourself and taking care of your health if you are sexually active.



Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke, Roach RE, Helmerhorst FM, Lijfering WM, Stijnen T, Algra A, Dekkers OM, The Cochrane database of systematic reviews, August 2015

Prevention opportunities for oral contraceptive-associated ischemic stroke, Ryan KA, Cole JW, Saslow K, Mitchell BD, McArdle PF, Sparks MJ, Cheng YC, Kittner SJ, Stroke, March 2014

Hormonal contraception, thrombosis and age, Lidegaard Ø, Expert Opinion on Drug Safety, October 2014

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