Stroke and steroid hormonal contraception.

The rate of stroke in young women has been falling for some years. The data presented here suggest that the relative risk associated with oral contraceptive use also is falling. This is probably due to a combination of younger age at use of oral contraceptives, lower steroid dose of preparations, and more systematic screening of potential users; particularly with respect to blood pressure. The risk associated with oral contraceptive use is greater for occlusive stroke but increases with age in hemorrhagic stroke. Risk of occlusive stroke increases with increasing doses of estrogen. The evidence for a risk related to type or dose of progestogen is less consistent, but there is no support for an increase in risk associated with use of desogestrel or gestodene.