Hormonal Contraceptives and Cerebral Venous Thrombosis Risk: A Systematic Review and Meta-Analysis
Open accessAbstract
Objectives: Use of oral contraceptive pills (OCP) has previously been shown to increase the risk of cerebral venous sinus thrombosis (CVST). Whether this risk varies by type of OCP use, duration of use and other forms of hormonal contraceptives is largely unknown. This systematic review and meta-analysis updates the current state of knowledge on these issues. Methods: We performed a search to identify all published studies on the association between hormonal contraceptive use and risk of CVST in women aged 15-50, using MEDLINE, EMBASE, Cochrane systematic review, the Cochrane Center for Clinical Trials and CINAHL. Risk of CVST was estimated using random effects models. Stratification and meta-regression were used to assess heterogeneity. Results: Of 861 studies reviewed for eligibility, quality, and data extraction, 11 were included in the final systematic review. The pooled odds of developing CVST in women of reproductive age taking oral contraceptives was over 7 times higher compared to women not taking oral contraceptives (OR=7.59, 95% CI 3.82 – 15.09). There is some indication that third generation OCPs may confer a higher risk of CVST than second generation OCPs, but this remains controversial. Data is insufficient to make any conclusions about duration of use and other forms of hormonal contraceptives and risk of CVST. Conclusions: OCP use increases the risk of developing CVST in women of reproductive age. Better studies are needed to determine if duration and type of hormonal contraceptive use modifies this risk.
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Estrogen is associated with increased risk of unusual site thromboses.
“Estrogen has also been associated with increased risk of “unusual site” thromboses, as well as arterial thrombosis.”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [92]
CHC use is associated with an increased risk of cerebral venous sinus thrombosis, with OR 5.59 (95% CI 3.95-7.91) and 7.59 (95% CI 3.82-15.09) in two separate meta-analyses.
“Multiple studies show an increase in the risk of cerebral venous sinus thrombosis, with an OR of 5.59 (95% CI 3.95 – 7.91) and 7.59 (95% CI 3.82—15.09) in two separate meta-analyses [91, 92].”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [92]
The absolute risk of cerebral venous sinus thrombosis remains very low, estimated around 2 per 100,000.
“However, the absolute risk remains very low, estimated around 2 per 100,000.”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [92]
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- Authors
- Amoozegar, F., Ronksley, P. E., Sauve, R., & Menon, B. K.
- Affiliations
- University of Calgary (CA)
- Ottawa Hospital Research Institute (CA)
- Corresponding author
- Menon, Bijoy K.
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2015-02-02
- Volume
- 6
- Pages
- 7-7
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC4313700
- OpenAlex
- W2011261631
- Cited by
- 107
- References
- 36
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 11 · 2023: 13 · 2022: 17 · 2021: 14 · 2020: 11 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 1 · 2015: 5
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Neurology › Cerebral Venous Sinus Thrombosis
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Neurology › Vascular Malformations Diagnosis and Treatment
- Keywords
- cerebral venous thrombosis, oral contraceptives, hormonal contraception, thrombosis risk, third-generation oral contraceptives, second-generation oral contraceptives, duration of contraceptive use, women of reproductive age
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