#Finland #Helsinki #Cryptogenic Stroke #ESOC 2025 #Contraceptives

Study Overview

At the European Stroke Organisation Conference (ESOC) 2025, fresh research was unveiled indicating that the use of combined oral contraceptives (OCs) may triply increase the risk of cryptogenic ischaemic stroke (CIS) among young women. This revelation adds to the growing evidence correlating hormonal contraception with elevated vascular risks in women who are of reproductive age.

Cryptogenic ischaemic stroke, defined as a stroke with no identifiable cause, constitutes up to 40% of all ischaemic strokes in the young adult demographic. Despite its prevalence, investigations into sex-specific risk factors, particularly contraceptive use, have remained limited. While there have been previous assertions connecting combined OCs with stroke risks, this recent study stands out by specifically targeting cryptogenic strokes in young women.

The SECRETO Study

Titled the Searching for Explanations for Cryptogenic Stroke in the Young (SECRETO) study, this research engaged 268 women aged between 18 and 49 years who had experienced CIS, in comparison with 268 stroke-free individuals of matching age. The study was conducted across 14 centers in Europe, with 66 patients and 38 controls currently utilizing combined OCs.

Upon adjusting for various factors such as age, hypertension, smoking, and conditions like migraines and abdominal obesity, the study established that the use of combined OCs correlated with an adjusted odds ratio of 3.00 (95% CI 1.61–5.57). Notably, no significant interactions surfaced between OC usage and these established risk factors, implying that the increased risk of stroke may function independently of other known risks.

According to Dr. Mine Sezgin, the lead author from Istanbul University’s Neurology Department, "Our results reinforce earlier conclusions that link oral contraceptives with stroke risks. What's particularly significant is the strength of this association, even when adjusted for various other recognized risk factors, hinting at potentially additional genetic or biological mechanisms at play."

Observations on Contraceptive Use

The majority of OC users in the study were on ethinylestradiol-based formulations, with a median dosage of 20 micrograms, alongside other varieties of estrogen, including estradiol hemihydrate and estradiol valerate.

"To ensure our findings maintain consistency, we calculated the equivalent estrogen dosage for each participant," added Dr. Sezgin. "Our data serves as important preliminary insights; however, larger studies are crucial to discern if specific formulations present differing levels of risk. This understanding could assist in fostering more personalized contraceptive choices for women."

Recommendations

While the authors of the study indicate that additional prospective studies are necessary, they also caution clinicians to be circumspect when prescribing combined OCs to women with known vascular risk factors or a previous history of ischaemic stroke. Dr. Sezgin articulated, "Our findings should encourage a more thorough assessment of stroke risks in young women, specifically those possessing additional risk factors."

Future Investigations

Looking ahead, researchers are keen to delve deeper into the biological and genetic mechanisms correlating combined OC usage with heightened stroke risk. The goal is to attain a clearer understanding of how hormonal contraceptives could independently escalate stroke risks.

Overall, the implications of this study extend beyond individual findings, prompting a reevaluation of how combined oral contraceptives are regarded in relation to vascular health, particularly among young women. This emerging data serves as a serious reminder to consider the ramifications of hormonal contraceptive methods on cardiovascular health.

About the European Stroke Organisation

The European Stroke Organisation (ESO) is a continent-wide assembly of researchers and medical professionals focusing on stroke treatment and education. Founded in December 2007, it aims to revolutionize stroke care through improved public and professional education and by advocating for substantial institutional changes.

In conclusion, this study sheds light on a critical healthcare issue, ensuring that the voices of those affected by strokes and reproductive health decisions are acknowledged and acted upon appropriately.