Contraceptive pill abuse and the risk of blood clots and stroke

Severe headache, weakness

The Stroke Department, Institute of Neurology, 108 Central Military Hospital (Hanoi) has just received and successfully treated 2 young female patients with stroke due to cerebral venous sinus thrombosis. Of which, 1 case was hospitalized in critical condition.

Lạm dụng thuốc tránh thai và nguy cơ huyết khối, đột quỵ - Ảnh 1. — New research warns women should seek medical advice if taking birth control pills long term

About 3-4 days before admission, the patient had a headache, painkillers helped a little, and he was still able to function normally. The day before admission, the patient had a severe headache. The patient was brought to the hospital in a state of impaired consciousness, continuous generalized convulsions, deep coma, quadriplegia, and dilated pupils.

The results of the brain CT scan determined that the patient had a large cerebral hemorrhage with bilateral parietal lobe transformation due to superior sagittal sinus thrombosis and sinus junction. The D-Dimer test (assessing the status of blood clots in blood vessels) was elevated above 5,000 ng/mL. After intensive treatment, the patient regained consciousness, was able to wean off the ventilator, communicate, and partially live independently.

Another case is a young female patient admitted to the hospital due to persistent headache, progressive weakness in the left side of the body, and difficulty walking. Based on the results of the scan and tests, the doctors diagnosed the patient with a right temporal cerebral infarction due to thrombosis in the straight sinus, sigmoid sinus, and left transverse sinus. The patient was treated with anticoagulants according to the protocol and recovered well, and was discharged from the hospital with the ability to live independently.

The risk is higher in women who smoke.

MSc. Nguyen Hai Linh, doctor of the Stroke Department (Institute of Neurology, 108 Central Military Hospital), added: The two female patients above were both using daily birth control pills for a long time. Daily oral birth control pills usually contain the hormones estrogen and progesterone, which work by inhibiting ovulation; thickening cervical mucus, preventing sperm from reaching the egg; changing the endometrium, preventing the egg from implanting. Long-term abuse can cause serious side effects, especially increasing the risk of thrombosis (blood clots).

According to general statistics in countries, the rate of venous thromboembolism in women using oral contraceptives is 3-6 times higher than in those who do not use them.

MSc. Nguyen Hai Linh (Department of Cerebral Stroke, Institute of Neurology, 108 Central Military Hospital)

Dr. Nguyen Hai Linh shared that, according to statistics collected in many countries, the rate of venous thromboembolism in women using oral contraceptives is 3-6 times higher than that of those who do not use them. Cerebral venous sinus thrombosis can cause complications of cerebral hemorrhage, or cerebral infarction, or a combination of bleeding and cerebral infarction. This risk is higher in women who smoke, are overweight, obese, or have a family history of stroke or thrombosis.

Do not arbitrarily prolong the time of taking birth control pills.

MSc. Nguyen Hai Linh noted: If you intend to use monthly birth control pills for a long time, women should see a specialist for examination, necessary tests and advice on safe and effective use of the drug; advice on the most suitable birth control method for your physical condition and health condition. In particular, do not arbitrarily use or prolong the time of taking the drug without professional instructions.

Besides birth control pills, you can consider methods such as: intrauterine device (IUD), contraceptive implant, sterilization (for those who no longer want to have children), condoms (simple, non-hormonal method).

New research

Some hormonal contraceptives are linked to an increased risk of stroke and heart attack, with the highest risk estimated for products containing estrogen, according to a large Danish study published in The BMJ (one of the world's oldest general medical journals) in February 2025. The study was based on prescription records of 2 million Danish women aged 15-49 from 1996-2021.

Accordingly, combined estrogen-progestin oral contraceptives were associated with a twofold increased risk of ischemic stroke and heart attack, equivalent to one stroke for every 4,760 women using combined oral contraceptives for 1 year and one heart attack for every 10,000 women using them per year.

The researchers stressed that although the absolute risk remains low, given the popularity of oral contraceptives and their severity for certain health conditions (age, high blood pressure, diabetes, overweight, smoking…), physicians should consider the potential risks when prescribing hormonal contraception.

It is estimated that nearly 250 million women worldwide use hormonal contraceptives. Previous studies have also shown that the risk of ischemic stroke and heart attack may increase with their overuse.

Phuong An

In Vietnam, according to a study by several leading obstetrics hospitals (2021), nearly 50% of women of childbearing age have used birth control pills, of which nearly 20% have used them continuously for more than 12 months without regular check-ups.