A Review on The Risk of Developing Stroke in Reproductive Women on Hormonal Contraceptives

Abstract

Background: Overall, quality of current evidence regarding the risk of ischemic stroke associated with the use of hormonal contraceptives is low. Available data suggests that combined hormonal contraceptives may further increase the risk of ischemic stroke in those who have migraines, hypertension, diabetes, are obese, and smoke. Hormonal contraceptive use might increase the risk of stroke in women. Aim: To identify scientific evidence regarding the risk of hormonal contraceptive use and the occurrence of stroke. Methods: Integrative review of the literature, Searches were made in the following databases: Scopus, Google scholar, science direct, Medline, PubMed, Cochrane Library and web of science using key descriptors “contraceptive agents”, “contraceptive devices”, “contraceptives oral’’ and “Stroke” for all studies published between 2010 and 2020. Original studies in English, published in full and available online were included. Studies that did not answer our guiding question, had incomplete studies, studies not published in English, only had an abstract and having irrelevant information were excluded from the study. Results: Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogens, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. Conclusion: Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives are recommended and considered safe.