Strokes without a known cause are called cryptogenic. It accounts for up to 40 per cent of all ischaemic strokes in young adults
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Taking birth control pills or combined oral contraceptives containing both oestrogen and progestin may triple the risk of cryptogenic stroke in young women, according to a study.
Strokes without a known cause are called cryptogenic. It accounts for up to 40 per cent of all ischaemic strokes in young adults. Despite its prevalence, the contribution of sex-specific risk factors, such as contraceptive use, has remained underexplored.
The findings add to a growing body of evidence linking hormonal contraception to vascular risk in women of reproductive age.
“Our findings confirm earlier evidence linking oral contraceptives to stroke risk,” said lead author Dr. Mine Sezgin, Department of Neurology, Istanbul University.
“What’s particularly notable is that the association remains strong even when accounting for other known risk factors, which suggests there may be additional mechanisms involved – possibly genetic or biological,” she added.
The research included 268 women aged 18-49 years with cryptogenic ischaemic stroke (CIS) and 268 age-matched stroke-free controls across 14 centres in Europe.
Of the participants, 66 patients and 38 controls were using combined combined oral contraceptives.
While the researchers note that further prospective studies are needed, they advise clinicians to exercise caution when prescribing combined oral contraceptives to women with known vascular risk factors or a history of ischaemic stroke.
“Our findings should prompt more careful evaluation of stroke risk in young women, particularly those with additional risk factors,” Dr. Sezgin said.
Next, the researchers plan to explore biological and genetic mechanisms underlying the observed association between combined oral contraceptive use and increased stroke risk to better understand how hormonal contraceptives may independently elevate stroke risk.
The findings were presented at the ongoing European Stroke Organisation Conference (ESOC) 2025 in Helsinki, Finland.
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