- Jenna Goldman had ocular migraines and was on birth control pills. Both raise the risk of stroke.
- She didn't know that until after she'd suffered a stroke that's left her numb on one side.
The first time Jenna Goldman experienced a blinding headache, she was sitting at her first post-collegiate desk job in New York City. She stumbled out of the office, hailed a cab, and sent herself to the hospital. There, clinicians told her she had ocular migraines, and that all would be well with some medication and rest.
One of the next times such a migraine struck, Goldman was walking with her now-husband Jason through the city's Soho neighborhood. By then, they knew the drill: "Get me home, put a cloth over my head, sit in a dark room for a few hours and just relax," Goldman, now a 28-year-old marketing and events professional, told Insider.
But the last time Goldman had an ocular migraine, it developed into more than a headache — it became, she learned later, a stroke. "It was very shocking, I couldn't understand it, I couldn't understand why me?" Goldman said. "I was so healthy, so young."
The one answer doctors settled on was birth control pills. The pills, when containing estrogen, raise the risk of clotting, and clots can lead to strokes. People who have regular ocular migraines, or migraines with aura, are also at an increased risk of stroke — and shouldn't be on hormonal contraceptives, according to the American College of Obstetricians and Gynecologists.
But Goldman didn't know that until it was too late. She shared her story with Insider to alert other young women of the stroke-related risks of birth control. "Always be super aware of what you put in your body, because I never really was until this happened to me," she said.
When Goldman went to the hospital, it was overrun with COVID patients
Goldman's stroke occurred in April 2020. She and Jason had taken over her parent's New Jersey house to escape the heart of the pandemic in New York City, and the couple had settled into healthy routines like morning walks and regular yoga.
But on one particular run, Goldman started experiencing a migraine with aura. An hour after returning to bed for a cold cloth and pain meds, she developed numbness on the left side of her body. She couldn't move or talk, then began sweating profusely.
"I felt like something just took over my body and threw me to the ground. I had no idea what was going on." Then, she started "projectile vomiting bile," she said.
When Jason, who'd run out for Excedrin and Gatorade, found her, he took her to the hospital. But it was overrun with COVID patients, and Goldman couldn't articulate the severity of her symptoms.
"The lights are so bright, I'm in so much pain, I haven't had water, I'm just a big mess, and no one's treating me," Goldman said. "They just think I'm a girl with a migraine."
Doctors did conduct a CT scan of her head and gave her medicine for the headache, but by 1 am, Goldman convinced Jason to take her home. "If I'm going to die," she said she thought, "I don't want to die here."
Goldman still has no feeling on her left side
The next day, Goldman experienced more left-side numbness and returned to the hospital, where she got an MRI.
This time, a nurse noticed Goldman's sorority sweatshirt, and told Goldman she'd been in the same sorority. "At that moment," Goldman said, "I knew we had a commonality and she was going to take care of me."
The MRI revealed Goldman had suffered "multiple small infarcts," or strokes across her brain, explaining Goldman's loss of feeling, vision problems, and speech difficulty. She was put on aspirin and taken off birth control, but didn't learn until later about the role her contraception played.
Goldman spent three days in the hospital and three months in physical therapy. "It was really stressful because a week before I was running, doing yoga, exercising," Goldman said. "And now this physical therapist is telling me to squeeze a ball and try to walk to the other side of the room."
But once she shifted her perspective to feeling grateful the damage hadn't been worse, Goldman improved.
Now, more than two years later, Goldman has earned her yoga teacher certification, and is back to work full time. She still has trouble concentrating, gets tired and hot easily, and the left side of her body feels numb. She can move her muscles on that side, but she can't feel a hot pan or her puppy's lick.
"There's a lot of good that came out of what happened to me, but there's a lot of wear and tear of my brain and my body," she said.
Strokes from birth control-linked blood clots are rare, but possible
In a follow-up appointment a week after her hospitalization, Goldman learned her birth control pills, plus history of migraine with aura, was likely the cause of her stroke. But it tooks months of testing to confirm it, she said.
"It was hard for everyone to come to that conclusion," she said, "because they were so taken aback that this could happen to someone who's 26 years old."
While research on the risk of pill-associated blood clots is flawed, it can generally be compared to rare but serious events like a car crash, Dr. Melanie Davies, a gynecologist in London and professor at University College London, previously told Insider for an earlier story related to the blood-clotting risks of the AstraZeneca vaccine.
"For 10,000 women over a year, one to five will have a blood clot anyway, and on the [pill] that rises to three to nine, so it is still less than one in 1,000 chance," she said.
The risk of a birth-control related blood clot becoming a stroke is about 8 in 100,000, according to UW Medicine. That risk is higher among women who have migraines with aura, though researchers don't know how much since studies on the topic are weak.
While rare, strokes could be rarer still if women — and their doctors — were more aware that hormonal birth control could put them at risk, Goldman said she thinks.
"If my gynecologist had ever told me that migraine and birth control don't go together," she said, "then I would have gotten off of anything estrogen related."