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Oral Contraceptives and Hormone Replacement Therapy May Protect Women Against Brain Aneurysms – or Not

A new study claiming protective benefits from artificial hormones is far from convincing.

AnnA Rushton

I used to idle away some pleasant hours on a book that I intended to write called ‘101 Alternative Uses For HRT’. Every time some negative publicity appeared they very shortly afterwards would be a “new” benefit.

For a brief period I actually kept a list but soon gave it up as they could think up new uses faster than I could keep up with my list. However, I am always optimistic that one of these new “benefits” will actually turn out to be real.

Rush University Medical Center have just published their results from a new study which suggest that oral contraceptives and hormone replacement therapy (HRT) may yield the additional benefit of protecting against the formation and rupture of brain aneurysms in women.

A cerebral aneurysm is a weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. As it does so it can put pressure on a nerve or surrounding brain tissue and may also leak or rupture, spilling blood into the surrounding tissue. Aneurysms can occur anywhere in the brain.

This is the first study of its kind and was prompted by the fact that the lead author of the study, Dr. Michael Chen, a neuro-interventionalist at Rush, had observed that in the two largest brain aneurysm trials to date, cerebral aneurysms occurred most frequently in post-menopausal women.

The two trials had found that 70 percent of aneurysms occurred in post-menopausal women with the mean age of 52 at a time of life coinciding with a severe drop in estrogen levels. Somehow I knew it would coincide with a drop in estrogen levels.

Yet again, as with the original trials on HRT, this is a small-scale study and the ages of the women who participated in the study ranged from 31-80 which doesn’t seem to be heavily weighted towards postmenopausal women. But then, I am neither a doctor or a medical researcher.

There are certainly many well established causes of cerebral aneurysm: congenital – resulting from an inborn abnormality in an artery wall, certain genetic diseases – such as connective tissue disorders and polycystic kidney disease, and certain circulatory disorders.

More everyday causes include trauma or injury to the head, high blood pressure, infection, tumours, diseases of the vascular system, cigarette smoking, and drug abuse – particularly the habitual use of cocaine which can inflame blood vessels.

The contraceptive pill and HRT both carry significant health risks and advocating a potentially hazardous medication in order to potentially prevent an aneurysm may be justifiable, but to my mind the case has certainly not yet been proved.

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