Study Links Oral Contraceptives to Increased Risk of Cryptogenic Stroke in Young Women
Research shows that combined oral contraceptives triple the risk of cryptogenic stroke in young women, highlighting the importance of personalized medical assessments.
Recent research presented at the European Stroke Organization Conference (ESOC 2025) in Helsinki has revealed a significant association between the use of combined oral contraceptives (OCs) and a threefold increase in the risk of cryptogenic ischemic stroke (CIS) among young women. CIS, which accounts for up to 40% of ischemic strokes in young adults, remains a perplexing condition due to its unclear cause, and the role of sex-specific risk factors like hormonal contraceptives is gaining attention.
The study, known as the SECRETO trial, involved 268 women aged 18 to 49 years who experienced CIS, alongside an equal number of age-matched controls without stroke history across 14 European centers. Notably, 66 women with CIS and 38 controls were using combined OCs. After controlling for variables such as age, hypertension, smoking, migraine with aura, and abdominal obesity, OC use was associated with an adjusted odds ratio of 3.00, indicating a threefold increased risk. The risk appears to be independent of other risk factors, suggesting that hormonal contraceptives may have a direct effect on stroke susceptibility.
Most women in the study were using ethinylestradiol-based formulations, with a median dose of 20 micrograms. Researchers emphasize the importance of understanding whether different contraceptive types carry varying risks, which can influence clinical decision-making. While larger, prospective studies are needed to confirm these findings, clinicians are advised to evaluate stroke risk carefully when prescribing combined OCs, especially to women with existing vascular risk factors.
Dr. Mine Sezgin from Istanbul University highlighted that the findings reinforce earlier evidence linking oral contraceptive use to stroke risk, suggesting that additional biological or genetic mechanisms might be involved. The ongoing research aims to clarify these mechanisms and improve personalized contraceptive guidance for women.
Ultimately, this study underscores the need for cautious use of hormonal contraceptives in young women and prompts healthcare providers to consider individual risk profiles to mitigate stroke risk. Further exploration into the biological underpinnings of this association may lead to safer contraceptive options in the future.
source: https://medicalxpress.com/news/2025-05-combined-oral-contraceptives-triple-cryptogenic.html
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