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New Delhi, May 23, 2025:
A recent study presented at the European Stroke Organisation conference in Helsinki has raised fresh concerns about the safety of combined oral contraceptives (COCs), commonly known as “the pill.” According to research conducted at Istanbul University, women who use COCs are three times more likely to suffer an unexpected stroke than those who do not.
Key Findings from the Study
The study analyzed 268 women aged 18 to 49 who experienced cryptogenic ischaemic strokes (CIS)—a type of stroke with no clear cause—and compared them with an equal number of women in the same age group without a stroke history. The results confirmed that COC use is strongly associated with an increased risk of stroke, even after accounting for other known risk factors.
Dr. Mine Sezgin, lead author and neurologist at Istanbul University, emphasized, “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.”
Expert Opinions
Healthcare professionals in India have responded to these findings with caution. Dr. Anuradha Kapur, principal director of obstetrics & gynaecology at Max Smart Super Specialty Hospital, explained, “Think of it as adding gasoline to a fire that has not yet been lit. If you have a genetic factor or already have a risk factor, the pill can be the trigger.”
Dr. Renu Gupta, director of obstetrics and gynaecology at Sri Balaji Action Medical Institute, added that COCs could trigger complications in women with underlying health conditions, such as undiagnosed thrombophilias or autoimmune disorders.
Prof. Manjari Tripathi, head of neurology at AIIMS, noted that the risk is especially high in women who smoke, have high blood pressure, migraines with aura, or a history of stroke. “COC usage increases ischaemic stroke risk by 1.6 to 2 times, with higher risks in women experiencing migraines with aura,” she said.
Modern Pills and Risk Factors
Dr. Vinit Suri, senior consultant of neurology at Indraprastha Apollo Hospitals, pointed out that modern contraceptive pills contain lower levels of oestrogen, which reduces the risk compared to older formulations. However, the risk remains significant for women who smoke, have hypertension, or are above 35 years of age. Interestingly, the absolute risk for healthy young women remains minimal, and pregnancy itself poses a higher stroke risk than oral contraceptives.
Dr. Bhaskar Shukla, consultant neurologist at PSRI Hospital, highlighted the importance of informed choice and regular health check-ups. He recommended considering non-oestrogen contraceptive methods for women with multiple vascular risk factors.
What Should Women Do?
Experts advise that women, especially those with known vascular risk factors or a history of ischaemic stroke, should consult their healthcare providers before starting COCs. Alternative contraceptive options, such as long-acting reversible contraceptives (LARCs), may be safer for some women.
Disclaimer:
This article is based on recent research findings and expert commentary. The information provided is for educational and informational purposes only and should not be construed as medical advice. Women considering oral contraceptives should consult their healthcare provider to discuss individual risks and benefits.
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