Oral contraception

Stroke in women of child-bearing age is uncommon, with a rate of 28 strokes per 100 000 women aged 15–44 reported in a community-based incidence study.

Several meta-analyses have reported conflicting findings depending on the oral contraceptive formulations used, which included pills with high concentrations of estrogens (>50 μg), newer combination pills, and progesterone-only pills.

If an association between oral contraception and stroke does exist, it is likely to be small in relative and absolute terms given the small number of events in this age group, particularly in women younger than 35 years who do not smoke and have normal blood pressure.

For current research and evidence-based recommendations see our Clinical Guidelines.