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Summary: Oral Contraceptives Can Increase Risk of Strokes in “Migrainous Women”

Oral contraceptives are known to be an independent risk factor for strokes, particularly in individuals who smoke, are over the age of 35, or have a history of hypertension.

  • According to a study published in the British Medical Journal (BMJ), migraines have been reported as a risk factor for strokes in males and in pre-menopausal women. The BMJ study also cited other studies that showed a substantially increased risk of stroke in women who had migraines and who used oral contraceptives. The researchers of that study advised that women should stop taking oral contraceptives if their migraine changed from simple to more severe. However, at the time of the writing of this article, no formal studies had examined whether a change in migraine type on starting oral contraceptives is a predictor of strokes in women. According to this study, oral contraceptives are known to be an independent risk factor for strokes, particularly in individuals who smoke, are over the age of 35, or have a history of hypertension. This risk is lower in women who use a low dose of contraceptives. The effects of migraines among women taking either low or high dose oral contraceptives upon the risk of developing a stroke have been previously un-established. For this reason, researchers aimed to investigate the association between migraines and strokes in young women. The case-controlled study consisted of women aged 20-44 years, based in five European countries, one-quarter of women who had had a stroke reported a personal history of migraine and one-quarter reported a family history of migraine. Overall, researchers found the risk of stroke among European women of childbearing age was increased more than three times if they experienced migraines. The researchers also found that a coexistence of risk factors such as the use of oral contraceptives, high blood pressure, or smoking had multiple effects on the odd ratios for strokes associated with migraines alone. 1

1Migraine and Stroke in Young Women: Case-Control Study, British Medical Journal, Vol. 318, January 2, 1999, pp. 13-18.

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