Hormonal contraceptives and IIH
Reviewed by Tasmin Berman

This multicentre retrospective population based case control study investigated whether there was a higher incidence of idiopathic intracranial hypertension (IIH) in those patients taking oral contraceptive pills (OCP) and other hormonal contraceptives. Fifty-three women were diagnosed with IIH between Jan 1990 and December 2016, 11 (20.8%) of those patients had used hormonal contraceptives within 30 days of diagnosis. These patients were matched by age and BMI to 96 controls, 30 (31.3%) of which were using hormonal contraceptives. In this study the rate of OCP use was 15.1% among IH patients, which is similar to use within the general population in the United States, 15.9%. The rate of long acting contraceptives is also similar, 9.8% in cohort compared with 8% nationally. This study concludes that OCP use was not associated with increased odds of IIH diagnosis, odds ratio 0.52 (95% confidence interval). In addition, hormonal contraceptive use of any kind was also not associated with IIH, with an odds ratio of 0.55 (95% confidence interval). A larger study is required to ensure further analysis of subgroups of contraceptives to exclude a potential link, as there have been variable reports in the literature.

A population-based, case-control evaluation of the association between hormonal contraceptives and idiopathic intracranial hypertension.
Kilgore K, Lee M, Leavitt J, et al.
AMERICAN JOURNAL OF OPHTHALMOLOGY
2019;197:74-9.