Using the combined oral contraceptive pill (combi pill) is linked to a small increase in the risk of stroke and blood clots for some people. When you are prescribed contraception, you should be checked for any risk factors like having a history of blood clots or stroke, having high blood pressure, being a smoker or being very overweight. You should be given advice about your options and what is safe for you. 

It’s the oestrogen in the pill that can cause blood clots or stroke, but the combi pill in use today has a much smaller amount of oestrogen than older types of pill. Strokes in younger people are rare, and the overall risk from using the pill is very low. But if someone has a stroke while on the pill, they will probably be advised to stop using it.

More information on contraception after a stroke.

Stroke is rare among pregnant women, but pregnancy and childbirth can increase your risk of a stroke. During pregnancy, regular blood pressure checks can spot the signs of pre-eclampsia, a condition that can increase the risk of a stroke.

Having a stroke during pregnancy or soon after birth might mean you and your family face multiple health concerns at a difficult time. The effects of a stroke some people experience, like one-sided weakness, fatigue or emotional changes, may make it harder to look after your baby. 

Your local health visitor service can support parents with babies and children up to five years old. Your health visitor can offer individual advice and help you find local support networks. The charity Tommy’s also provides information and support around pregnancy and early childhood, while Gingerbread has information for single parents with disabilities.

Migraine affects more women than men. Although it’s not a direct cause of stroke, it’s linked with an increased risk if you have migraine with aura. Although the added risk of stroke due to migraine is small, it means you might not be able to use the combined oral contraceptive pill if you have migraine with aura.

Our migraine and stroke page has more information.

Lupus is an autoimmune condition affecting the skin and joints. It can cause pain, tiredness and sometimes kidney damage. The severe form is called systemic lupus erythematosus (SLE). This condition is linked to an increased risk of stroke. 

SLE mainly affects women below the age of 50, and is more common in people of African, Caribbean or South Asian origins. If you have SLE, you should be monitored and given treatment to manage your condition. 

Lupus UK offers more information.

Giant cell arteritis is also known as temporal arteritis. It is a type of blood vessel inflammation (vasculitis) that affects more women than men.

The arteries at the side of the forehead become inflamed and may cause symptoms such as severe headaches, pain or tenderness at the side of the head, jaw pain while eating or talking, or vision problems. It’s important to seek urgent medical help because if the blood supply to the brain is affected, it can cause a stroke. 

Giant cell arteritis is usually treated with steroids, and you may be offered other medication to help reduce your risk of stroke. 

The NHS website has more information.

Cavernous sinus thrombosis is a rare blood clot that tends to occur more often in women than men, including pregnant women or those using contraceptives with oestrogen. It happens when blood clots form within the skull, blocking blood draining out of the brain. This can sometimes lead to a stroke. 

The main symptom of cavernous sinus thrombosis is often a headache, usually causing sharp pain around the eye area, and you may have swollen, painful or red eyes, or vision problems. You may also have a fever, seizures or vomiting, and you can also have signs of stroke such as confusion or weakness down one side. 

Symptoms might come on more gradually than a typical stroke. There may be other causes for these symptoms, but you should get medical help as soon as possible to get them checked and get any treatment you need. 

Cavernous sinus thrombosis is usually treated with antibiotics. You may also be given an injection of the anticoagulant heparin, and you might be given blood-thinning tablets to reduce the risk of another clot. 

The NHS website has more information. 

In the years running up to the menopause, women can start to have more risk factors for stroke such as diabetes, high blood pressure and weight gain. It’s thought oestrogen protects your heart and blood vessels, helping to reduce the risk of a stroke while you’re still having periods (menstruating). 

After menopause, the risk of a stroke starts to rise. This is also true if you had an early menopause (before the age of 45) or have medical treatment or surgery that stops oestrogen production. You can help reduce your risk of stroke by following any medical treatment you need for conditions that increase the risk of stroke (such as high blood pressure) and by having a healthy lifestyle. 

Treating menopausal symptoms 

Hormone replacement therapy (HRT) is one of the main treatments for menopausal symptoms such as hot flushes and night sweats. It can also help prevent bones from becoming weak (osteoporosis). 

Current NICE guidelines on treating menopause say, in women with no previous history of stroke, HRT tablets can slightly increase the risk of stroke. Other forms of HRT, such as patches, sprays and gels, are unlikely to increase the risk of stroke. 

After a stroke, it may be possible to take HRT, but you should speak to your doctor for individual advice on the benefits and risks and to find out what is available to you. Using HRT also depends on other health conditions you may have and the medications you use. You may be referred to a specialist. 

The NHS website has more information on menopause symptoms and sources of support.

Staying healthy after stroke when you’re menopausal 

If you are going through the menopause after a stroke, there are some things that will help you be healthy and reduce your risk of another stroke. Being active and having a healthy diet can help you manage conditions like high blood pressure and diabetes and maintain a healthy weight. 

Being active can also help maintain bone health, as well as improving fatigue and low mood. If you’re not sure where to start, ask your GP or stroke nurse for advice.