Questioning Medicine2 Jul 2024

Episode 312: 311. Risk of Stroke in Women Using Levonorgestrel-Releasing Intrauterine Device for Contraception

https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.124.047438

We studied the risk of IS and ICH in women using LG-IUDs—aka mirana-- compared to women not using hormonal contraceptives.

The commonly used combined hormonal contraceptives with progestins and ethinylestradiol are associated with an increased risk of ischemic stroke (IS).

In this Danish historical cohort study (2004-2021) we followed non-pregnant women (18-49 years) registering incident IS and ICH in relation to use of LG-IUD/non-use of hormonal contraceptives utilizing Danish high-quality registries with nation-wide coverage.

A total of 1,681,611 non-pregnant women A total of 1,681,611 non-pregnant women

The numbers get huge here however--

After adjustment incidence rate ratio for IS was 0.78 (CI: 0.70; 0.88), and for ICH it was 0.94 (CI: 0.69; 1.28)

Use of LG-IUD was associated with a 22% lower incidence rate of IS without raising incidence rate of ICH. I think IUD are unutilized and now we have data that says they have lowers rates of stroke.

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