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Time of India
22-05-2025
- Health
- Time of India
Oral Contraceptives May Triple Stroke Risk
New Delhi: Women who use a combined oral contraceptive (COC)—better known as the pill—are three times more likely to suffer an unexpected stroke than those who don't. These new findings were presented at a conference of European Stroke Organisation in Finland's Helsinki on May 20. The pill is a hormonal contraceptive, containing both oestrogen and progestogen , which prevents the ovaries from releasing an egg each month. A research at Istanbul University in Turkiye has established the connection between cryptogenic ischaemic stroke (CIS) and oral contraceptives. The research analysed 268 women, aged 18 to 49 years, who experienced unexpected strokes, comparing them with 268 women in the similar age group without a stroke history. Studies from 2019 and 2022 highlighted similar concerns. The discovery of direct vascular effects of COCs requires immediate attention. Healthcare professionals acknowledge that extended usage periods and increased oestrogen levels heighten stroke risks. Dr Anuradha Kapur, principal director (obstetrics & gynaecology) and head of the unit at Max Smart Super Specialty Hospital, Saket, pointed out that while medicines could notably raise the likelihood of ischaemic strokes, they typically required existing risk elements to cause harm. "Think of it as adding gasoline to a fire that has not yet been lit. If you have a genetic factor or already have a risk factor, the pill can be the trigger," she clarified. However, research findings demonstrated that the increased stroke risk associated with oral contraceptive use appears to operate independently, as no significant associations were found between contraceptive usage and other documented risk factors. "Our findings confirm earlier evidence linking oral contraceptives to stroke risk," said Dr Mine Sezgin of the neurology department at Istanbul University and the lead author of the study. "What's particularly notable is that the association remains strong even when accounting for other known risk factors, which suggests there may be additional mechanisms involved—possibly genetic or biological." Dr Renu Gupta, director of obstetrics and gynaecology at Sri Balaji Action Medical Institute Delhi, emphasised that stroke resulted from multiple factors, including genetic, physiological and lifestyle-related risks. She noted that COC could trigger complications in women with underlying health conditions, including undiagnosed thrombophilias or autoimmune conditions. While the researchers note that further prospective studies are needed, they advise clinicians to exercise caution when prescribing the pill to women with known vascular risk factors or a history of ischaemic stroke. Describing the connection between oral contraceptives and stroke, prof Manjari Tripathi, head of the neurology department at AIIMS, explained that COC usage consistently correlated with increased ischaemic stroke risk, particularly in women with pre-existing health risk factors. COC usage increases ischaemic stroke risk by 1.6 to 2 times, with higher risks in women experiencing migraines with aura. The risk intensifies for women who smoke, have high blood pressure, migraines with aura, or a stroke history. The oestrogen component potentially increases blood coagulability and clot formation. Dr Vinit Suri, senior consultant of neurology at Indraprastha Apollo Hospitals, noted that first-year usage presented the highest risk, affected by oestrogen dosage. Modern pills contain lower oestrogen levels, reducing risks compared to older formulations, he pointed out. Risk increases with smoking, hypertension or age above 35. Healthy young women face minimal absolute risk, with pregnancy presenting higher stroke risks than oral contraceptives. "The real risk lies in stacking oestrogen on top of other vascular triggers—smoking, uncontrolled hypertension or migraine with aura—where non-oestrogen methods are clearly the wiser bet," said Dr Bhaskar Shukla, consultant neurologist at PSRI Hospital. Informed choice, annual check-ups and the growing menu of highly effective LARC devices mean women no longer have to trade peace of mind for modern contraception, he added.
The Sun
20-05-2025
- Health
- The Sun
Common medication taken by millions of Brits linked to triple risk of deadly stroke
THE combined pill has been linked to triple the risk of sudden stroke in young women, a new study has revealed. It's already well established that the pill, taken by over 3 million women in the UK, can increase the risk of blood clots and heart issues. Now, scientists based in Turkey have also linked it to a higher chance of cryptogenic ischaemic stroke (CIS) - a type of brain bleed with no clear cause. The new findings were presented at the European Stroke Organisation Conference in Helsinki, Finland today (May 20). Researchers from Istanbul University looked at 268 women aged 18 to 49 who had sudden, unexplained strokes, and compared them to 268 women of the same age who hadn't had a stroke. Among those who had strokes, 66 were using the combined contraceptive pill compared to just 38 in the control group. After accounting for factors like smoking, high blood pressure, migraines and obesity, they found women on the pill were three times more likely to suffer a cryptogenic stroke. The combined pill contains oestrogen and progestogen - and it's the oestrogen that's been linked to a higher risk of blood clots, which can lead to strokes. However, strokes in younger people are rare, and the overall risk from using the pill is very low, according to the Stroke Association. It's important to always speak to your doctor and pharmacist when thinking of coming off a medication. Earlier this year, a Danish study suggested the combined pill increases the risk of stroke two-fold. But in this study, experts have found a link to cryptogenic strokes, specifically. The 2 forms of contraceptive 'most likely to trigger deadly heart attack and stroke' revealed 'Our findings confirm earlier evidence linking oral contraceptives to stroke risk,' said Dr Mine Sezgin, lead author of the study. 'What's particularly notable is that the association remains strong even when accounting for other known risk factors, which suggests there may be additional mechanisms involved – possibly genetic or biological.' The experts said more studies are needed to firmly establish the link. But they also urged doctors to be careful when prescribing combined oral contraceptives to women with existing stroke risks or a history of ischaemic stroke. 'Our findings should prompt more careful evaluation of stroke risk in young women, particularly those with additional risk factors,' Dr Sezgin, said. How to choose the best method of contraception THERE are numerous contraception options available on the NHS and privately, and finding the right one for you can take time. Things to consider when deciding what contraception to use include how often you need to use it. Some methods, like the coil, are long acting, while others you need to take every day or use every time you have sex, like the pill and condoms. Hormonal methods of contraception can also sometimes leave users with side effects like headaches, feeling sick, mood swings, weight gain, sore breasts and acne. These types can carry a very small risk of health issues like blood clots and breast cancer too, meaning hormonal methods won't be suitable for everybody. On top of this, some types will be more effective than others. The implant and coil are deemed to be 99 per cent effective at preventing pregnancy, as is the pill and patch if used correctly. But condoms can sometimes break and methods like natural family planning - tracking when you're most fertile and avoiding sex at those times - tend to be less effective. Speak to your GP about which of the following might suit you best: Combined pill (contains progestogen and oestrogen) Mini pill (contains progestogen only) Copper coil or intrauterine device (inserted into the womb and doesn't contain hormones) Hormonal coil or intrauterine system (inserted into the womb and releases progestogen) Implant (inserted under the skin on your arm and releases progestogen) Injection (progestogen) Patch (worn on the skin and releases progestogen and oestrogen) Vaginal ring (put in the vagina and releases progestogen and oestrogen) Condoms (worn on the penis) Internal condoms (put in the vagina before sex) Female sterilisation (permanently stops eggs meeting sperm) Vasectomy or male steralisation (permanently stops sperm being ejaculated) Diaphragm or cap (put inside the vagina before sex to stop sperm getting into the womb) Natural family planning (includes tracking your menstrual cycle to avoid sex when you are most fertile) Morning after pill (to be used in emergency situations three to five days after sex) Source: NHS
