Oral contraceptives are a unique risk factor for cardiovascular disease in women.
Most of the current oral contraceptives are combined estrogen and progestin, which may increase the risk of stroke.
A cohort study from China showed a significantly higher incidence of haemorrhagic stroke in women using oral contraceptives compared to women using IUDs, and the incidence of haemorrhagic stroke did not decrease for some time after stopping the pill.
The risk of stroke is significantly increased when oral contraceptives are combined with stroke risk factors such as advanced age, hypertension, diabetes, hyperlipidaemia, obesity and smoking.
In patients with migraine (especially migraine with aura), oral contraceptives increase the risk of ischaemic stroke.
Therefore, oral contraceptives are not recommended for women aged >35 years with risk factors for stroke.