The Link Between Birth Control Pills and Stroke

Oral contraceptives have been around for years and have given women substantial reproductive freedom. In addition to functioning as birth control, oral contraceptives may also be prescribed for the management of certain medical conditions.

A woman holding birth control pills

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Overall, they are considered safe, and newer formulations are even safer and easier to use than in the past.

But, there is an elevated risk of blood clots with the use of oral contraceptives. Many women wonder how significant those risks are and if the risk of stroke while using oral contraceptives is enough reason to avoid them.

Hundreds of thousands of women have used oral contraceptives over the years, so there is enough data to provide real answers to questions about an association between oral contraceptives and stroke.

Link Between Oral Contraceptives and Stroke Risk

Women who take oral contraceptives are twice as likely to suffer from a stroke than their counterparts who do not take them. It is important to understand the risk for stroke is already very low in this population, so a doubled risk does not mean the risk is high—especially among women without other risk factors.

In one study, non-smoking women with normal blood pressure who were taking low-dose oral contraception had an annual stroke risk of 8.5 per 100,000, compared with 4.4 per 100,000 among women not taking birth control.

Most women who use oral contraceptives are under the age of 35-40, as women over that age generally rely on more permanent means of birth control. So, with a population of relatively young women taking oral contraceptives, strokes associated with oral contraceptive use are quite rare, even with the relative increase in stroke risk associated with them.

How Different Formulations Affect Risk

Studies that show an increased risk of stroke associated with oral contraceptives consistently note that those with a higher dose of estrogen are the ones most strongly associated with stroke. Authors of one of the largest research studies on the subject recommended using oral contraceptives formulated with less than 50 micrograms of estrogen to prevent stroke.

Most significantly, women with certain health conditions constitute the vast majority of women who experience strokes related to the use of oral contraceptives.

Health-Related Risk Factors

Women who are smokers or who have already been diagnosed with blood-clotting disorders are the most likely to experience a stroke while taking oral contraceptives. Some other conditions associated with a higher tendency to blood clots and strokes while taking oral contraceptives include polycystic ovary syndrome and hypertension.

Several research studies suggest that women who suffer from migraines with aura also have an elevated chance of stroke when taking birth control pills, although this link is not as definitive as that seen with the medical conditions listed above. A migraine with aura is a type of migraine headache accompanied by neurological symptoms, such as vision loss, tingling, or weakness.

Birth Control Safety Among Teenagers

Overall, teenagers are not at higher risk of birth control pill-related stroke than women who are in their 20s or 30s. This means that, while there is a slight risk of having a stroke while using birth control pills, the likelihood of becoming pregnant if you are sexually active and not using birth control far outweighs the risk of having a stroke with birth control pills.

Stroke safety is an especially important question for young women who are making a decision about whether to use oral contraceptives, because young women may be less likely to recognize the symptoms of a stroke or a TIA.

Studies show that teenagers are often unaware of the risk of stroke or of the side effects of birth control pills. If you are a teenager taking birth control pills, you should learn how to recognize the symptoms of a stroke, and you should stay responsible by protecting yourself and taking care of your health if you are sexually active.

A Word From Verywell

Hormonal therapy and hormonal contraception can be important in reproductive planning and managing illness. Overall, hormonal medications are considered very safe. However, as with most medications, they may produce side effects or medical complications, including the risk of stroke. For example, estrogen therapy is linked with lower stroke risk in some instances and higher stroke risk in other instances.

The best way to optimize your health is to take medications that are beneficial for your overall quality of life and to learn how to recognize complications so that you can manage them in a timely manner.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Carlton C, Banks M, Sundararajan S. Oral contraceptives and ischemic stroke risk. Stroke. 2018 Apr;49(4):e157-e159. doi: 10.1161/STROKEAHA.117.020084.

  2. Dulicek P, Ivanova E, Kostal M, et al. Analysis of risk factors of stroke and venous thromboembolism in females with oral contraceptives use. Clin Appl Thromb Hemost. 2018;24(5):797-802. doi:10.1177/1076029617727857

  3. American College of Cardiology. Oral contraceptives and ischemic stroke risk. March 28, 2018.

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.