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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Combined Oral Contraceptives and Stroke Risk in Individuals With Migraine With Aura
Liza R Gibbs1, Matthew P Fox, Hugo J Aparicio
1Department of Epidemiology, Boston University School of Public Health, and the Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, and the Boston Collaborative Drug Surveillance Program, Lexington, Massachusetts; and Aetion, a Datavant Company, New York, New York.
Obstetrics and Gynecology
|May 7, 2026
Summary
The risk of stroke is low for women with migraine with aura using either combined oral contraceptives (COCs) or progestogen-only pills (POPs). Study findings indicate similar stroke risk between these contraceptive types.
Area of Science:
- Reproductive Health
- Neurology
- Cardiovascular Health
Background:
- Migraine with aura is a known risk factor for stroke.
- Combined oral contraceptives (COCs) contain estrogen and progestogen, while progestogen-only pills (POPs) do not.
- The comparative risk of stroke between these contraceptive types in individuals with migraine with aura requires further investigation.
Purpose of the Study:
- To compare the risk of stroke in individuals with migraine with aura using COCs versus POPs.
- To estimate the risk difference for ischemic and any stroke between COC and POP users.
- To inform contraceptive choices for individuals with migraine with aura.
Main Methods:
- Utilized U.K. primary care and hospital records (Clinical Practice Research Datalink).
- Included individuals aged 15-49 with migraine with aura who initiated COCs or POPs between 2000-2024.
- Employed Kaplan-Meier estimator with treatment and censoring weights to compare stroke risk.
Main Results:
- 1-year risk of ischemic stroke was 17.36/100,000 for COCs and 17.62/100,000 for POPs.
- Weighted 1-year risk difference for ischemic stroke was 9.53/100,000 (95% CI, -38.65 to 57.71).
- Risk differences were small and imprecisely measured, with similar findings in sensitivity analyses.
Conclusions:
- Overall stroke risk is low in reproductive-age individuals with migraine with aura.
- No significant difference in stroke risk was observed between COC and POP users.
- Findings suggest similar safety profiles regarding stroke risk for both contraceptive types in this population.
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