New research results, which were presented today at the Conference of the European Stroke Organization (ESOC) in 2025, show that the use of combined oral contraceptives (OCS) is connected to young women with a triple increased risk of cryptogenic ischemic stroke (CIS).(1) The results fit into a growing number of evidence that establish a connection between hormonal contraception and vascular risk in women of reproductive age.
The cryptogenic ischemic stroke, i.e. a stroke without a recognizable cause, accounts for up to 40 % of all ischemic strokes in young adults. (2) Despite its prevalence, the contribution is gender -specific risk factors, such as: B. the use of contraceptives has not yet been sufficiently researched. While earlier studies combined OCS have associated the risk of stroke, this is one of the few studies that focus on cryptogenic strokes in young women.
The study “Searching for Explanation for Cryptogenic Stroke in the Young” (Secreto) comprised 268 women aged 18 to 49 with CIS and 268 -the -way control persons without a stroke in 14 European centers. Of the participants, 66 patients and 38 controllers combined OCS. After considering age and known comorbidities such as high blood pressure, smoking, migraines with aura and abdominal obesity, the use of OC was connected to an adjusted ODDS ratio of 3.00 (95 % CI): 1.61–5.57). There were no significant interactions between taking OC and these risk factors, which suggests that the increased risk of stroke exists regardless of other known factors.
“Our results confirm earlier references to a connection between oral contraceptives and the risk of stroke,” said Dr. Mine Sezgin from the Department of Neurology at the University of Istanbul and the main author of the study. “It is particularly noteworthy that the association remains strong even if other known risk factors are taken into account, which indicates that additional – possibly genetic or biological – mechanisms could be involved.”
Most OC users in the study took formulations based on ethinyl estradiol, with an average dose of 20 micrograms. Other estrogen species such as estradiolhemihydrate and estradiolvalerat were also recorded.
“We have calculated the equivalent estrog dose for every patient to ensure consistency,” explains Dr. Sezgin. “Our data provide important initial findings, but larger studies are required to determine whether certain formulations are associated with different risks. This knowledge could help to better support women in choosing their contraceptive.”
The researchers point out that further prospective studies are necessary, but advise the doctors to caution if they prescribe women with known vascular risk factors or a history of ischemic strokes. “Our results should be the reason to evaluate the risk of stroke more carefully in young women, especially for women with additional risk factors,” concluded Dr. Sezgin.
The researchers plan to investigate the biological and genetic mechanisms that are based on the observed connection between the combined use of OK and the increased risk of stroke in order to better understand how hormonal contraceptives can increase the risk of stroke independently.
Note to the editors:
All reports and/or articles related to this study must include an indication of ESOC 2025.
Information on the author of the study:
Dr. Mine Sezgin is a neurologist and stroke researcher at the medical faculty of the University of Istanbul. Their work focuses on gender -specific risk factors and stroke prevention in young adults.
Information about the European Stroke Organization (ESO) (ESO):
The ESO is a pan -European society of stroke researchers and doctors, national and regional stroke companies and lay organizations, which was founded in December 2007.
The aim of the ESO is to reduce the stroke of the stroke by changing the way the stroke is viewed and treated. This can only be achieved through professional and public education as well as through institutional changes. The ESO is the voice of stroke in Europe, harmonizes stroke treatment throughout Europe and takes measures to reduce the stress due to the stroke regionally and worldwide.
References:
1. Sezgin, M., et al. Hormonal contraception increases the risk of cryptogenic stroke in young women. Abstract O049, presented at the conference of the European Stroke Organization; May 21, 2025; Vienna, Austria.
2. Yaghi, S., & Elkind, M. S. (2014). Cryptogenic stroke: A diagnostic challenge. Neurology. Clinical practice, 4(5), 386–393. https://doi.org/10.1212/CPJ.0000000000000086
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