Secondary prevention

 

Oral contraception

• Approximate doubling of risk of first ischaemic stroke in women using combined (low-dose) oestrogen pill
• Equates to very small increase in absolute risk (especially for younger women)
• Unclear how this affects women with prior history of stroke /TIA
• Limited evidence that methods containing progesterone (oral, implant and injectable) showed no significant risk
• Full range of contraceptive methods (hormonal and non-hormonal) should be considered when making decision

Recommendation 5.9.1

A. The combined oral contraceptive pill should not be routinely prescribed following ischaemic stroke