These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Relationship of migraine headache and stroke to oral contraceptive use.
    Author: Benson MD, Rebar RW.
    Journal: J Reprod Med; 1986 Dec; 31(12):1082-8. PubMed ID: 3540297.
    Abstract:
    Are oral contraceptive users who also suffer from migraine headaches at higher risk of having a cerebrovascular accident? The data are inconclusive in establishing that women who used the relatively higher-dose pills prescribed in the 1960s have a higher risk of either thrombotic or hemorrhagic stroke. Furthermore, a review of the literature does not support the belief that those women who use oral contraceptives have a higher incidence of migraine headache. The available data do not indicate that migraine headache is necessarily a contraindication to prescribing oral contraceptives. Three studies directly evaluated the effects of oral contraceptive (OC) use on migraine headache frequency. The Walnut Creek Study in 1980 was unable to demonstrate a higher frequency of migraine headache in OC users discharged from the hospital as compared with nonusers. Another study in 1978 evaluated the effect of 0.5 mg of norgestrel and 50 mcg of ethinyl estradiol (Ovral) on 40 migraine sufferers. 20 patients received this preparation for the first 2 months of the study, the other 20 did not. 29 patients experienced worsening of their headaches with OC use. However, one-third of the patients did note improvement in their headaches. A third study in 1976 of women suffering from migraine suggested that about one-third of women noted worsening of their headaches while taking OCs. The risks of cerebrovascular accident (CVA) include advancing age, smoking, and the use of high-dose pills. Increase in blood pressure, platelet aggregatability, and cholesterol deposition are the three known mechanisms of the risk of stroke. No blind study of the subject has even been made, and a significant minority of OC users reported improvements in their migraine headaches. Circumstantial evidence suggests that there is an increased risk of stroke in OC users, although these case control studies differed with regard to the degree of relative risk. Two of three cohort studies were unable to demonstrate the increased risk of CVA among these women. The absolute risk of thrombotic stroke remains small for OC users, and the absolute risk is probably very small even for those taking OCs. However, the risk of hemorrhagic stroke may increase fivefold in those smoking. For nonsmokers, OC use is probably safer in all age groups than no contraception. A 1977 study showed that 40-44 year old nonsmokers taking OCs had an estimated death rate of 7/100,000. In contrast, those who used no method of contraception had a higher mortality rate of 23/100,000.
    [Abstract] [Full Text] [Related] [New Search]