Objective:

This case report aims to investigate the potential link between the topical application of Oral Contraceptive Pills (OCPs) and the development of Cerebral Venous Thrombosis (CVT) in a male patient, broadening our understanding of CVT risk factors.

Background:

CVT is a relatively rare but extremely severe subtype of stroke, known for its debilitating consequences. It has a range of established risk factors, including the use of Oral Contraceptive Pills (OCPs). However, the majority of research and clinical observations focus on the systemic use of these pills. The potential link between topical application of OCPs and the risk of CVT is an area of study that remains largely unexplored and not well-understood.

Design/Methods:

Case report

Results:

A 37-year-old male developed CVT after using a homemade topical OCP solution (cyproterone acetate and ethinylestradiol) for three months for hair growth. He presented with a sudden, intense right-sided headache. A CT venogram revealed CVT, with a filling defect in the right internal jugular vein and sigmoid, transverse, and straight cerebral venous sinuses. Comprehensive tests ruled out other potential causes, such as autoimmune conditions, thrombosis, and infectious diseases. The case was managed with immediate discontinuation of the OCP solution, anticoagulation therapy, and close monitoring of the patient's condition.

Conclusions:

This case report draws attention to the potential risk of CVT associated with the topical use of OCPs, particularly in males who are not the typical demographic for these pills. It emphasizes the need for in-depth research to understand the effects of topical hormonal therapies, including OCPs, on CVT and venous thromboembolism risk in male patients. Given the widespread use and accessibility of OCPs and the potential for misuse, such research is vital for informing clinical practice, improving patient safety, and shaping future guidelines on hormone-based therapies.