Until now,no sufficient Literature data exist about combined hormonal contraceptives delivered by a different route (transdermal patch, vaginal ring, subdermal implant ).

Instead, a cohort study reported no stroke relief among 49,048 women-years of transdermal contraceptive system exposure,  and 10 among   norgestimate-containing   oral   contraceptive   users   (44).

In   conclusion, current available studies indicate that there is no significant increase in the risk of ischaemic stroke or acute myocardial infarction associated with the use of low-dose estrogen COCs in women properly screened before use,  and who have no pre-existing cardiovascular risk factors.

Rosa Sabatini and Giuseppe Loverro
Dept. Obstetrics and Gynecology,
General Hospital Policlinico-University of Bari, Italy

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