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Forum Name: Gynecology

Question: BCP risks


 butters123 - Wed Jan 18, 2006 10:06 pm

I am 27 and have been on the pill for 10 years. My mom recently tol me she had a stroke when she was in her twenties when she was on the pill shorthly after she gave birth to my brother, but due to being poor she never went in. So no tests were ever done. She said her arm was flaccid and eveything but it came back on its own. My question is should I get off the pill, I quit smoking a year ago, but I am paranoid. I told my doctor but she acts likes she not concerned. Should I be? And what other options do I have I do not want kids, Im allergic to spermicide, I will not take depo(heard horror stories) and my hubby is not keen on condoms. Help.
 Theresa Jones, RN - Thu Jan 19, 2006 7:30 am

User avatar Hi butters123,
There has been exhaustive research on oral contraceptives since the 1960's. The low dose oral contraceptive used today, although still carries risks, (always listed in the insert provided in each pack of pills) are much safer today as compared to prior years. According to the FDA women whom are healthy, non-smokers, have very little if any greater risk, of suffering serious health problems than women who do not use the pill at all. If you have been on the pill for this extended period of time and have had no serious side effects and do not have risk factors then your chances, although not impossible of course, would likely be very low of developing an adverse health issue. If you do decide to continue taking oral contraceptives, according to studies, supplementing your diet with a calcium supplement, to decrease the risk of osteoporosis is advised. If you and your husband are absolutely sure that neither of you want children, sterilization is also an option that both of you may want to inquire about with your physician's.
Sincerely,
Theresa Jones, RN
 Dr. Tamer Fouad - Thu Jan 19, 2006 8:10 am

User avatar Hello,

The risk of thromboembolism and stroke in women that use oral contraceptives has been debatable. However, the use of oral contraceptives that contain low-dose oestrogens and third-generation progestagens have made the absolute risk for stroke in young women very small.[1]

Oral-contraceptive users are at increased risk if they have any of the following risk factors: the presence of a thrombophilia, such as factor V Leiden, advanced age (greater than age 30 years), smoking, hypertension, diabetes, obesity and unfavorable lipid profile. As with hormone therapy, screening for risk factors and markers of stroke risk in women could be useful before oral contraceptives are prescribed.[1]

On the other hand having a positive family history of stroke in a first-degree relative (especially if that relative was under the age of 65 when he got the stroke) should alert someone that they are probably at increased risk of stroke themselves.[2]

Researchers in this large British study found that a family history of vascular disease at age 65 or younger is an independent risk factor for both large-vessel and small-vessel stroke.[2]

They also that participants with large-vessel strokes were almost three times as likely as controls to have an immediate family member who had suffered stroke at age 65 or younger or a family member who had a heart attack.

I think if you are concerned about stroke then the first step for you is to properly evaluate your risk of stroke by assessing the factors mentioned above and discussing your overall risk with a neurologist.

Best regards.

References:
==========
1. Cheryl D Bushnell. Oestrogen and stroke in women: assessment of risk. Lancet Neurol 2005; 4: 743–51.
2. Jerrard-Dunne P, Cloud G, Hassan A, Markus HS. Evaluating the genetic component of ischemic stroke subtypes: a family history study. Stroke. 2003 Jun;34(6):1364-9.

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