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Do Birth Control Pills Increase The Risk For Stroke?
Question: Hi - I previously has a stroke due to a chiropractic neck manipulation. This was 10 years ago. I would now like to start a low does birth control pill for hot flashes but my doctor is concerned since I have had a strok in the past that I may not be a good candidate. I am asking because this stroke was not caused by my body clotting but instead by the chiropractor. Can you give me your opinion on this? Is it a problem because the artery is not a smooth surface or is it a problem because they think My body could create a clot? Thank you for any information!
Brief Answer:
Read below.
Detailed Answer:
Hello! I read your question and I understand your concern.
Birth control pills are known to constitute a risk for stroke. However that risk is lower than once thought. Also they have been more associated with cerebral venous thrombosis than arterial stroke which was probably the case in your first stroke.
Now in your case it would have been useful to know some more info on the mechanism of stroke. The fact that it was related to chiropractic manipulation makes me think it was due to a cervical artery dissection but it would be useful to have it confirmed just to make sure.
Also while the manipulation can be the precipitating factor, it is often the case that individuals are predisposed for it due to some condition affecting the connective tissue (conditions such as Marfan syndrome, Ehlers Danlos, muscular fibrodysplasia etc), have the doctors at the time investigated that possibility? If such a condition is present then you remain a person at a higher stroke risk.
Also did you have any control imaging later, if there was a dissection was the artery lumen open or were there still irregularities.
The answers to these questions would help estimate your stroke risk, because it is a question of risk percentages, not certainties.
If it was a cervical artery dissection, without any connective tissue condition from tests, considering that it is more a question of increased risk for venous thrombosis rather than arterial, I would say that the risk is very low. However preventive treatment with Aspirin might be a wise precaution.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
Hello! I read your question and I understand your concern.
Birth control pills are known to constitute a risk for stroke. However that risk is lower than once thought. Also they have been more associated with cerebral venous thrombosis than arterial stroke which was probably the case in your first stroke.
Now in your case it would have been useful to know some more info on the mechanism of stroke. The fact that it was related to chiropractic manipulation makes me think it was due to a cervical artery dissection but it would be useful to have it confirmed just to make sure.
Also while the manipulation can be the precipitating factor, it is often the case that individuals are predisposed for it due to some condition affecting the connective tissue (conditions such as Marfan syndrome, Ehlers Danlos, muscular fibrodysplasia etc), have the doctors at the time investigated that possibility? If such a condition is present then you remain a person at a higher stroke risk.
Also did you have any control imaging later, if there was a dissection was the artery lumen open or were there still irregularities.
The answers to these questions would help estimate your stroke risk, because it is a question of risk percentages, not certainties.
If it was a cervical artery dissection, without any connective tissue condition from tests, considering that it is more a question of increased risk for venous thrombosis rather than arterial, I would say that the risk is very low. However preventive treatment with Aspirin might be a wise precaution.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the information. This was a vertebral artery dissection. The right vertebral artery was dissected from C2 just into the brain. They did MRI with contrast to confirm. To the best of my knowledge, I was not diagnosed with Marfan Ehlers etc.) and have had three follow up visits back when this happened and was cleared and told I didn't need to come back for follow up visits. I will go back and see if I can get the full chart from the Hospital to verify. Thank you again.
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Brief Answer:
You're welcome.
Detailed Answer:
Thank you for that additional info. My guess would be that you don't have any other accompanying issue or you would've been told. So as I said the added risk related to the combination of birth control pill and dissection should be very low.
I hope to have been of help.
You're welcome.
Detailed Answer:
Thank you for that additional info. My guess would be that you don't have any other accompanying issue or you would've been told. So as I said the added risk related to the combination of birth control pill and dissection should be very low.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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