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Even increased risk of stroke with Pill use is small, study says

July 5, 2000
Web posted at: 12:21 p.m. EDT (1621 GMT)

(CNN) - Use of oral contraceptives has long been known to increase women's risk of stroke. But that risk is still miniscule, according to a study published Tuesday in the Journal of the American Medical Association.

Dr. S. Claiborne Johnston and colleagues at the University of California, San Francisco, analyzed 16 earlier studies and found that women's risk of stroke roughly doubles with use of the low-dose birth control pills typically prescribed today. The risk again doubles with higher doses of estrogen.

However, Johnston noted, "the risk is so low to begin with that even when risk doubles, it remains low." Women's stroke risk further increases due to advancing age, hereditary and lifestyle factors and underlying conditions such as heart disease and diabetes.

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    Source: WebMD

    Statistically, pill usage increased the risk of stroke to two out of 24,000, accounting for perhaps some 400 additional strokes each year among American women of childbearing age, the study estimated.

    But pregnancy also carries risk. According to the Centers for Disease Control and Prevention, every year as many as 500 women die in the United States from causes directly related to pregnancy such as bleeding, blood clots, high blood pressure, infection and heart disease. An additional 500 to 800 deaths may be attributable to pregnancy, the CDC noted.

    Increased stroke risk "probably shouldn't influence most women's decision about whether they use oral contraceptives," Johnston said.

    "It's possible we’re underestimating the relative risk of low dose oral contraceptives in our study because fewer high risk women are being prescribed the drug," he continued. Risk of stroke connected to oral contraceptives is known to increase especially among smokers over the age of 35.

    Still, high blood pressure and smoking are risk factors for stroke by themselves. So doubling the stroke risk will be more significant among this high-risk group.

    Some 10 to 16 million U.S. women take the pill, and 78.5 million worldwide do.

    If we were to remove oral contraceptives from the market in the United States and replace them with condoms, we would expect about 400 fewer strokes each year, but the cost would be 690,000 additional unintended pregnancies," Johnston said. "Oral contraceptives certainly aren't perfect, but they work very well."

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