Idiopathic Intracranial Hypertension Prevalence and Hormonal Contraception: A Meta-Analysis

Area of Science:

• Neurology
• Gynecology
• Public Health

Background:

• Idiopathic intracranial hypertension (IIH) management is complicated by concerns regarding hormonal contraception (HC).
• Existing advice on HC use for women with IIH is inconsistent.
• A potential association between HC and IIH prevalence remains a concern.

Purpose of the Study:

• To systematically review and meta-analyze the association between HC use and IIH prevalence.
• To clarify the relationship between various HC modalities and IIH.
• To provide evidence-based guidance for clinicians and patients.

Main Methods:

• Systematic literature searches of major databases (MEDLINE, Embase, Cochrane Library) and gray literature.
• Inclusion of observational studies comparing HC use in women with and without IIH.
• Random-effects meta-analysis and subgroup analyses stratified by HC type, with sensitivity analyses.

Main Results:

• Thirteen studies including over 5,300 IIH cases and 669,000 controls were analyzed.
• No significant association was found between overall HC use and IIH prevalence (OR 0.93).
• Subgroup analyses showed no significant associations for oral contraceptive pills, intrauterine devices, or injections.

Conclusions:

• The meta-analysis demonstrates no significant link between hormonal contraception and idiopathic intracranial hypertension.
• This evidence supports the continued appropriate use of HC for women with IIH.
• Further large-scale, well-designed studies are needed to confirm findings and address evidence limitations.