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Oral, hormonal contraceptives do not promote idiopathic intracranial hypertension

09 Oct 2018

Use of oral contraceptive pills (OCPs) and other hormonal contraceptives does not appear to pose an increased risk of developing idiopathic intracranial hypertension (IIH), a study reports.

Researchers compared the use of contraceptives between 53 female IIH patients and 96 matched controls. The entire cohort had a median age of 27 years and body mass index of 38 kg/m2.

In the IIH group, 11 women (20.8 percent) had used hormonal contraceptives, eight (15.1 percent) OCP and five (9.8 percent) non-OCP within 30 days of diagnosis. In the control group, 30 women (31.3 percent) had used hormonal contraceptives, 22 (22.9 percent) OCP and eight (8.4 percent) non-OCP.

In conditional logistic regression models, neither use of OCP (odds ratio [OR], 0.52; 95 percent CI, 0.20–1.34; p=0.174) nor of non-OCP hormonal contraceptives (OR, 1.31; 0.38–4.45; p=0.671) was associated with increased odds of IIH diagnosis. Moreover, hormonal contraceptive use of any kind showed no association with IIH (OR, 0.55; 0.24–1.23; p=0.146).

The present data argue against the need for women with IIH to discontinue their use of OCPs or other hormonal contraceptives.

Researchers cited several reasons why hormonal contraceptive is thought to potentially increase IIH risk. First, young females of reproductive age at the highest risk of IIH are also most likely to be using contraceptives. Second, hormonal contraceptives are known to induce a prothrombotic state and are the most frequent risk factors for cerebral venous thrombosis in women. [Clin Appl Thromb Hemost 2018;24:217-225; https://www.cdc.gov/nchs/products/databriefs/db173.htm]

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