Physicians should consider type and dose of progestin and estrogen, along with method of administration when prescribing hormonal contraceptives. Ideally the best drug is the one with the lowest amounts of progestin and estrogen doses which will provide the required result of pregnancy prevention while minimizing adverse side effects.
Healthy young women who do not have any risk factors for stroke have a very small risk associated with use of oral contraceptives. Women with other risk factors for stroke have a higher risk, and use should be discouraged. Factors include, cigarette smoking, migraine headaches, and high blood pressure.
Women are not always screened adequately. One study found only 15% of women with stroke risk factors being advised not to take oral contraceptives, 36% remember being told to stop, and 15% continue to take them despite being told to stop. Findings point out the need to improve patient counseling and encouragement of patient compliance.
