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Combined oral contraceptives triple risk of cryptogenic stroke in young women

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New research has revealed that the use of combined oral contraceptives (OCs) is associated with a threefold increase in the risk of cryptogenic ischaemic stroke (CIS) in young women.

The findings add to a growing body of evidence linking hormonal contraception to vascular risk in women of reproductive age.

Cryptogenic ischaemic stroke, which is stroke with no identifiable cause, accounts for up to 40 per cent of all ischaemic strokes in young adults. Despite its prevalence, the contribution of sex-specific risk factors, such as contraceptive use, has remained underexplored.

While prior studies have associated combined OCs with stroke risk, this is among the few studies to focus specifically on cryptogenic stroke in young women.

The Searching for Explanations for Cryptogenic Stroke in the Young (SECRETO) study included 268 women aged 18 to 49 years with CIS and 268 age-matched stroke-free controls across 14 centres in Europe. Of the participants, 66 patients and 38 controls were using combined OCs. After adjusting for age and established comorbidities such as hypertension, smoking, migraine with aura, and abdominal obesity, OC use was associated with an adjusted odds ratio of 3.00.

No significant interactions were found between OC use and these risk factors, suggesting that the increased stroke risk may operate independently of other known contributors.

“Our findings confirm earlier evidence linking oral contraceptives to stroke risk,” said Dr. Mine Sezgin, Department of Neurology, Istanbul University, and lead author of the study.

“What’s particularly notable is that the association remains strong even when accounting for other known risk factors, which suggests there may be additional mechanisms involved – possibly genetic or biological.”

Most OC users in the study were taking ethinylestradiol-based formulations, with a median dose of 20 microgrammes. Other types of oestrogen, such as estradiol hemihydrate and estradiol valerate, were also recorded.

“We calculated the equivalent oestrogen dose for each patient to ensure consistency,” Dr Sezgin said.

“While our data provides important initial insights, larger studies are needed to determine if certain formulations carry different levels of risk. This knowledge could help guide more personalised contraceptive choices for women.”

While the researchers note that further prospective studies are needed, they advise clinicians to exercise caution when prescribing combined OCs to women with known vascular risk factors or a history of ischaemic stroke.

“Our findings should prompt more careful evaluation of stroke risk in young women, particularly those with additional risk factors,” said Dr. Sezgin.

Moving forward, the researchers plan to explore biological and genetic mechanisms underlying the observed association between combined OC use and increased stroke risk to better understand how hormonal contraceptives may independently elevate stroke risk.

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What “women’s healthmaxxing” means for patient trust and the femtech industry

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Women’s health has become one of the most searched and shared topics online, from cycle syncing and cortisol management to menopause hacks, supplements, hormone testing and clinician-creator content.

That surge in attention, sometimes dubbed “healthmaxxing,” is changing how women find, evaluate and act on health information, and it is starting to reshape the relationship between patients, clinicians and the companies building products for this market.

For providers, the shift means patients are arriving better informed but also more exposed to unverified claims, putting pressure on clinicians to engage with online narratives rather than dismiss them.

For femtech and pharma companies, it opens a route to reach and educate consumers at scale, but also raises the stakes on credibility: products and messaging that ride the trend without clinical grounding risk eroding the trust the industry has spent years building.

Investors are watching the same dynamic from a different angle.

Attention-driven demand can be a signal of where the next wave of femtech growth will come from, but distinguishing genuine clinical need from viral momentum is increasingly part of due diligence.

The net effect is a widening gap between companies that treat cultural attention as a distribution channel for credible, evidence-based care, and those that risk being swept up in trends with little clinical substance behind them.

How that gap plays out will shape patient trust, clinical relationships and commercial opportunity across the women’s health industry for years to come.

These themes will be explored in more depth in an upcoming webinar, “Women’s Healthmaxxing: The Opportunity & Risks of Cultural Attention for the Women’s Health Industry,” hosted by the Women’s Health Innovation Summit (WHIS), featuring Ellen Wilcox (Listen Ventures), Jessica Bell van der Wal (Frame Fertility), Dr. Tosin Sotubo-Ajayi (NHS, BBC and more) and Nora Lansen (Elektra Health).

Register free for the webinar on 23 July 2026 at https://events.virtualpro.com/womens-health-series-webinar-july-2026/registration

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Rising number of young midwives quitting NHS due to burnout

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More young midwives are leaving the NHS before 35 as burnout adds pressure to stretched maternity services, new research has revealed.

The trend has raised concerns about the quality and safety of care for mothers and babies in understaffed maternity units.

During 2025-26, 1,669 midwives aged 34 or under left the health service in England, representing 57 per cent of the 2,949 midwives of all ages who resigned.

The pressures of maternity care, including increasingly complex childbirth and the risks involved, are thought to be among the factors behind the trend.

Hannah Leonard, deputy chief midwife at the Royal College of Midwives, said the exodus of midwives under 35 was “deeply worrying” and showed that too many were ending up “burnt-out within a few years of qualifying because every shift means too few colleagues, missed breaks and unpaid hours”.

She added: “Losing these midwives, and students, even before they qualify, is a terrible waste of talent.”

The figures, revealed in parliamentary questions tabled by the Liberal Democrats, show that 205 of last year’s younger leavers were under 25, while 655 were aged 25 to 29 and 809 were aged 30 to 34.

The number of midwives under 35 leaving the NHS has risen sharply in recent years. The 2025-26 figure was 59 per cent higher than the 1,051 who left in 2014-15, according to NHS figures.

Burnout means long-term physical and emotional exhaustion, often linked to sustained pressure at work.

Separate figures obtained by the Liberal Democrats suggest almost one in four midwifery students are leaving before completing their three-year degree.

In 2021, 3,565 students started a midwifery degree, but 2,725 graduated in 2024, meaning 840, or 24 per cent, did not complete the course.

Midwifery students spend much of their second and third years learning on the job in maternity units.

The loss of staff and students underlines what the Royal College of Midwives has described as a “staffing emergency” in maternity care across the UK.

A recent survey by the Royal College of Midwives found that three-quarters of midwives had considered leaving the profession over the last year, mainly because of concerns over staffing levels and patient safety.

Both recent large-scale reviews of maternity care in England, led by Donna Ockenden and Valerie Amos, identified staffing shortages as a key problem affecting patient safety.

Helen Morgan, the Liberal Democrat health spokesperson, said: “These statistics reveal an alarming crisis in maternity, with far too many midwives burning out early in their career and in their training. Patients are paying the price, and mothers are left with no alternative but to give birth on understaffed and unsafe wards.

“Rather than throw money at yet more new recruits who quit under intolerable pressure, the government needs a new approach. Through guaranteeing protected, year-round training and professional development we can help midwives cope with rising complexity and risk.”

About 10 per cent of all midwives leave the NHS each year.

However, the figures show higher leaving rates among younger midwives, with one in seven, or 14.6 per cent, of those aged 25 to 29 and one in six, or 16.6 per cent, of those aged 30 to 34 leaving during 2025-26.

A Department of Health and Social Care spokesperson said: “Under this government we have a record number of midwives in the workforce and we value the vital service they provide in maternity and neonatal units across the country.

“To make the NHS the best employer it can be, we have introduced new NHS staff standards to improve health and wellbeing support, promote flexible working, as well as crucial measures to tackle violence, sexual harassment or abuse and racism.

“Alongside consecutive above-inflation pay rises, we’ve bolstered the midwifery workforce through our graduate guarantee and recently opened up 1,000 more midwifery roles backed by £10m to help prevent student midwives leaving the profession.”

Department of Health and Social Care figures show a record 25,500 full-time-equivalent midwives are working in the NHS, 2,000 more than when the Labour government took office in July 2024.

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Mental health

Nearly 60% of young women get health advice from influencers, research finds

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Nearly six in ten young women get health and wellness advice from influencers, new research shows.

Women aged 18 to 29 were more likely than young men to use online influencers for health information.

The topics included beauty, alternative medicine, mental health, weight loss and fitness.

The Pew Research study found that 57 per cent of women aged 18 to 29 said they get health and wellness information from online influencers, 10 percentage points higher than young men.

While Americans still mostly rely on healthcare providers, the research suggests social media influencers also play a major role in how young people find health advice.

Among women who get health and wellness information from influencers, 51 per cent said they often hear about beauty and appearance, compared with 18 per cent of men.

Young women were also around twice as likely as young men to say they see content about alternative medicine, meaning treatments or health practices used outside mainstream medical care.

A third or more of both young men and young women said they often hear about mental health and weight loss from influencers.

Around half or more of both groups said they often see fitness content.

When asked why they seek health and wellness information from influencers, around half of young women said they wanted to make a change to their health or lifestyle.

That compared with 37 per cent of young men.

The research also found that 23 per cent of young women said hearing from people who share their background or beliefs was one reason they used influencers, compared with 14 per cent of young men.

A further 19 per cent of young women said they learnt about things they did not want to ask their doctor, compared with 10 per cent of young men.

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