Birth Control Pills, Migraines, and Stroke

Is There an Increased Risk of Stroke from Birth Control Pills and Migraines?

Birth control pills in plastic tablet dispenser case
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Birth control, migraines and stroke sometimes go hand in hand. Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). A transient ischemic attack, or "mini stroke", is caused by a temporary clot.

According to the American Stroke Association, of the 6.8 million Americans who have survived a stroke, 3.8 million are female.

This is primarily true because stroke increases with age. Seventy-five percent of strokes occur in people over 65 – and women live longer than men. By 2030, almost a fifth of Americans will be over age 65, and the majority will be women. In addition, stroke is the third leading cause of death for women while it ranks fifth for men.

Women who take birth control or who have migraines are typically young and have a very low risk of suffering a stroke. However, their risk of stroke increases due to certain habits and behaviors, as well as with the existence of some medical conditions.

Birth Control Pills Increase Stroke Risk

Many studies have shown that women who take birth control pills have an increased risk of stroke, especially when they use pill preparations that contain more than 80 micrograms of estrogen. Because of this, it is recommended that women on birth control pills use preparations that contain fewer than 50 micrograms of estrogen, which significantly decreases the risk.

The stroke risk from birth control pills is especially high in women who smoke, as this detrimental combination is often blamed for ischemic and hemorrhagic strokes.In addition, women planning to take birth control pills should be screened for hypertension (high blood pressure) and treated if they have it.

 Hypertension is the leading cause of stroke.

Migraines with Aura Increase Stroke Risk

Women who suffer from the type of migraines heralded by an aura also have an increased risk of suffering a stroke. And although the risk is still pretty small (1.5-2 times that of people without migraine), it can become much higher in women who both have migraines with aura, and smoke cigarettes.

A migraine with aura is a migraine preceded by an unusual phenomenon such as seeing sparkling lights or wrinkly lines in the field of vision. Though rare, some auras also include abdominal pain, transient numbness or weakness on either side of the face, arm or leg, vertigo, and sometimes, a feeling of déjà vu.


Larry B. Goldstein, MD et al. Guidelines for the Primary Prevention of Stroke . A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011;42:517-584.

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