Most users of hormonal contraceptives (HCs) have a low background incidence of major cardiovascular diseases.
In fact,current users of low estrogen dose – HC s have a small increased risk of ischaemic stroke, although most of the risk occurs in women with other risk factors, notably hypertension, age, smoking, and a history of migraine (20,21,22).
Particularly, the risk of ischaemic stroke among current users with a history of hypertension was evaluated 10.7 (odds ratio) (23).
Similarly, the use of HC increases the risk of haemorrhagic stroke in women aged over 35 years (odds ratio greater than 2) and when they have a history of hypertension, this risk is 10-15 fold compared with women who did not use COC s and did not have a history of hypertension (24).
Odds ratio among current users who are also current cigarette smokers was greater than 3. Past users of HCs do not seem to have an increased risk of stroke.
Adverse Effects of Hormonal contraception
- Cardiovascular Effects
- - Myocardial Infarction
- - Stroke
- - Arterial Accidents
- - Venous Thromboembolism
- - Blood Hypertension
- Other Effects
- - Angioedema
- - Peliosis Hepatis
- - Severe Adverse Ocular Reactions
- - Vasculitis
- Moderate adverse effects
- Cancer Risks
- - Breast cancer risk
- - Ovarian cancer risk
- - Endometrial cancer risk
- - Cervical cancer risk
- - Colorectal cancer risk
- - Skin cancer risk
- - Liver cancer risk
- - Pancreatic cancer risk
- - Neurofibromas growth
- - Unclear cancer risks
- Hazardous prescription
- Hormonal contraception in female transplant recipients
- - Hormonal contraception in female kidney recipients
- - Hormonal contraception in female liver transplant recipients
- - Hormonal contraception in female heart transplant recipients
- - Contraception in women HIV infected
- Mild Adverse effects
- New Perspectives immunocontraception
- Contraceptive counseling
The risks are similar for subarachnoid and intracerebral haemorrhage. (25). After the introduction of low-dose oral contraceptives, a decline in cerebral thromboembolism among young women has been reported (26).
However, cerebrovascular occlusion in young women may be caused by hormonal contraceptive use when unsuspected free protein S or protein C deficiency, coagulation factor XIII gene variation or inherited thrombophilia exist (27,28,29,30).
The role of inherited prothrombotic conditions as factor V Leiden, and prothrombin mutation in the pathogenesis of ischemic stroke is not well established; although it seems that carriers of the factor V Leiden mutation might have a 11.2 fold higher risk of ischemic stroke than women without either risk factor (31,32).
A prospective cohort study on 44,408 women on low-dose oral contraceptives and 75,230 with an intrauterine device(IUD) followed during three years, reported a higher incidence of haemorrhagic stroke than ischemic stroke (34.74 versus 11.25 per 100,000 woman years)for HC users.