Progestogen-Only Contraceptives and the Risk of Stroke

Chakhtoura, Zeina; Canonico, Marianne; Gompel, Anne; Thalabard, Jean-Christophe; Scarabin, Pierre‐Yves; Plu‐Bureau, Geneviève

doi:10.1161/strokeaha.108.538405

Cited by 87 publications

(41 citation statements)

References 38 publications

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“…217 Lastly, a systematic review of progestogen-only OCs revealed no significant increased risk of stroke with this form of contraceptive. 218 Two additional large cohort studies have been published since these meta-analyses. The first is the Women's Lifestyle and Health Cohort Study.…”

Section: Oral Contraceptivesmentioning

confidence: 99%

Guidelines for the Prevention of Stroke in Women

Bushnell¹,

McCullough²,

Awad³

et al. 2014

Stroke

767

414

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1545Purpose-The aim of this statement is to summarize data on stroke risk factors that are unique to and more common in women than men and to expand on the data provided in prior stroke guidelines and cardiovascular prevention guidelines for women. This guideline focuses on the risk factors unique to women, such as reproductive factors, and those that are more common in women, including migraine with aura, obesity, metabolic syndrome, and atrial fibrillation. Results-We provide current evidence, research gaps, and recommendations on risk of stroke related to preeclampsia, oral contraceptives, menopause, and hormone replacement, as well as those risk factors more common in women, such as obesity/metabolic syndrome, atrial fibrillation, and migraine with aura. Conclusions-To more accurately reflect the risk of stroke in women across the lifespan, as well as the clear gaps in current risk scores, we believe a female-specific stroke risk score is warranted. (Stroke. 2014;45:1545-1588.)

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Section: Oral Contraceptivesmentioning

confidence: 99%

Guidelines for the Prevention of Stroke in Women

Bushnell¹,

McCullough²,

Awad³

et al. 2014

Stroke

767

414

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“…[19][20][21][22][23] Although arterial events are less common than venous thromboembolism in women of reproductive age, the sequelae of stroke and myocardial infarction may be more devastating than those of venous thromboembolism. A large Danish cohort study found that women aged 45-49 years had 20 times the risk of stroke and 100 times the risk of myocardial infarction as women aged [15][16][17][18][19]. In this cohort, estrogen-containing contraceptive use increased the overall risk of stroke by as much as 2.2 times and of myocardial infarction by as much as 2.3 times.…”

Section: Cardiovascular Eventsmentioning

confidence: 81%

“…15 Two recent meta-analyses showed no association between progestin-only methods and arterial events. 16,17 Use of estrogen-containing contraceptives increases the risk of venous and arterial thromboembolic events. Other risk factors include, but are not limited to, age, obesity, smoking, diabetes, hypertension, migraine headaches (with or without aura) and thrombogenic mutations.…”

Section: Cardiovascular Eventsmentioning

confidence: 99%

Contraception in women over 40 years of age

Allen

Cwiak

Kaunitz

2013

CMAJ

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“…Oral contraceptives have been reported to be a risk factor for stroke, with an increased risk by about 4 times for pills with a high estrogen content, twice for pills with low estrogen content, and no increased risk for pills with progestagen alone. 31 However, stroke risks with oral contraceptives also appear to be modified by the presence of migraine and prothrombotic genetic variants. 8 Data on oral contraceptive use were only available for about one third of the female patients in sifap, in whom a prevalence of 30.5% was found.…”

Section: Discussionmentioning

confidence: 99%

Acute Cerebrovascular Disease in the Young

Heuschmann¹,

Jungehülsing²,

Giese³

et al. 2013

Stroke

192

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Background and Purpose-Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods-Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396) *Drs Rolfs, Fazekas and Grittner contributed equally to this work. Authors contributions: Dr Rolfs has conceptualized, initiated, and designed and organized the study, has been involved in the recruitment of the patients, and wrote significant parts of the manuscript. Dr Fazekas was involved in the study planning and has done together with Drs Enzinger and Schmidt the analysis of all MRI scans; this group was mainly involved in the statistical analysis of the MRI data. Drs Martus, Grittner, Holzhausen have taken responsibility for all statistical analysis and for the data structure of the total data bank. Drs Dichgans, Böttcher, Tatlisumak, Tanislav, Jungehulsing, Putaala, Huber, Bodechtel, Lichy, Hennerici, Kaps, Meyer, Kessler have been most active in the recruitment of the patients, drafting the manuscript and significantly influencing the scientific discussion. Dr Heuschmann was involved in drafting the manuscript and influencing the scientific discussion. Dr Norrving chaired the steering and publication committees of sifap, has written parts of the manuscript, and has significantly influenced the scientific discussions. Drs Lackner and Paschke, H. Mascher, Dr Riess have been involved in the laboratory analyses. Dr Kolodny has mostly contributed to the discussion of the Fabry cases. Dr Giese assisted in writing and editing the manuscript. All authors have reviewed, critically revised and approved the final version of the manuscript.The sponsors of the study had no role in the study design, data collection, data analysis, interpretation, writing of the manuscript, or the decision to submit the manuscript for publication. The academic authors had unrestricted access to the derived dataset, and assume full responsibility for the completeness, integrity, and interpretation of the data, as well as writing the study report and the decision to submit for publication.†Listed in Appendix I in the online-only Data Supplement. Jeffrey L. Saver, MD, was guest editor for this article.

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Progestogen-Only Contraceptives and the Risk of Stroke

Cited by 87 publications

References 38 publications

Guidelines for the Prevention of Stroke in Women

Guidelines for the Prevention of Stroke in Women

Contraception in women over 40 years of age

Acute Cerebrovascular Disease in the Young

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