Oral Contraceptives Increase Risk of Ischemic Stroke in Young Women

Women who use combined oral contraceptives face a threefold higher risk of cryptogenic ischemic stroke, a type of stroke with no identifiable cause. This conclusion stems from newly released findings that strengthen existing concerns over the vascular risks posed by hormonal contraceptives in women of reproductive age (1^✔ ✔Trusted Source
ESOC 2025: Combined oral contraceptives triple risk of cryptogenic stroke in young women, new study shows

Go to source). Cryptogenic ischemic stroke accounts for nearly 40% of all ischemic strokes in young adults, yet the role of sex-specific risk factors, particularly contraceptive use, has remained largely unexamined. Previous research has flagged a potential connection between oral contraceptives and stroke, but few studies have zoomed in on this specific form of stroke in young women.

Cryptogenic Stroke Risk Evaluated in Young Women

The SECRETO study examined 268 women between the ages of 18 and 49 who had experienced cryptogenic ischemic stroke and compared them with 268 age-matched stroke-free women across 14 centers in Europe. Among participants, 66 stroke patients and 38 controls were using combined oral contraceptives. After adjusting for factors like age, smoking, hypertension, migraines with aura, and abdominal obesity, the researchers found that contraceptive use alone tripled the risk of stroke. Importantly, this elevated risk appeared to act independently of other common contributors.

Dr. Mine Sezgin, lead author and neurologist at Istanbul University, emphasized the significance of the findings. “The strength of the association, even after accounting for other risk factors, suggests there could be other underlying mechanisms at play—potentially biological or genetic,” she noted.

Formulation Types and Estrogen Doses Under Review

The majority of women in the study were using contraceptives based on ethinylestradiol, with a median estrogen dose of 20 micrograms. Other estrogen types, such as estradiol hemihydrate and estradiol valerate, were also represented. Researchers calculated each participant’s total estrogen exposure to maintain consistency across the study group (2^✔ ✔Trusted Source
Cryptogenic stroke

Go to source).

Dr. Sezgin stressed that while these findings offer early insight, much larger investigations will be needed to determine whether different contraceptive formulations carry varying levels of risk. Understanding these distinctions could eventually support more personalized approaches to contraception, tailored to individual risk profiles.

Caution Urged in Clinical Decisions

Although further prospective research is required, the study’s authors advise clinicians to exercise caution when prescribing combined oral contraceptives to women with existing vascular risk factors or a prior history of stroke. “These results should prompt a more thorough risk assessment for stroke, especially in young women who already face additional health concerns,” Dr. Sezgin concluded.

Future research will explore the potential genetic and biological factors that may explain why oral contraceptives independently elevate the risk of cryptogenic stroke. Such findings could deepen understanding of vascular health in women and help refine safer contraceptive options. In conclusion, combined oral contraceptives increase the risk of unexplained ischemic stroke in young women, making it essential to consider individual health factors when choosing contraception.

References:

1. ESOC 2025: Combined oral contraceptives triple risk of cryptogenic stroke in young women, new study shows - (https://www.prnewswire.co.uk/news-releases/esoc-2025-combined-oral-contraceptives-triple-risk-of-cryptogenic-stroke-in-young-women-new-study-shows-302458942.html)
2. Cryptogenic stroke - (https://www.neurology.org/doi/10.1212/CPJ.0000000000000086)

Source-Medindia