Cerebrovascular occlusion in a transsexual man taking mestranol

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Abstract
Women (598) from age 15 to 44 yr with cerebrovascular disease were previously studied. The use of oral contraceptives was significantly more prevalent in women who had suffered a thrombotic stroke than in women who had not had strokes. The risk of thrombotic stroke was estimated to be 9 times greater in users of oral contraceptives than in nonusers. A case is reported in which a previously healthy man who was using an oral contraceptive drug developed middle cerebral artery occlusion. In the absence of other predisposing factors in this case, it appears that the cerebrovascular occlusion was related to estrogen administration. The occurrence of persistent severe headaches in patients using estrogenic hormones may be a clue to impending cerebrovascular occlusion.