• Diana Lara Pinto de Santana, Mariangela Barbi Gonçalves, Vanessa Milanese Holanda Zimpel, and Eberval Gadelha Figueiredo.
• Hospital Sírio Libanês - São Paulo (SP), Brazil.
• Rev Assoc Med Bras (1992). 2023 Jan 1; 69 (suppl 1): e2023S118e2023S118.

ObjectiveThe aim of this study was to carry out a systematic review of the literature with meta-analysis to evaluate the effect of using oral contraceptive and hormone replacement therapy as a protective factor in the formation of intracranial aneurysms and subarachnoid hemorrhage.MethodsThis is a systematic review of the literature with meta-analysis, using PubMed and Embase as databases and the PRISMA method. Case-control and cohort studies published until December 2022 were included in this review.ResultsFour studies were included in this review; three of which were eligible for meta-analysis. Regarding the use of oral contraceptive and the development of subarachnoid hemorrhage, there was a lower risk of aneurysm rupture with an odds ratio 0.65 (confidence interval 0.5-0.85). In the analysis of patients using hormone replacement therapy and developing subarachnoid hemorrhage, there was also a lower risk of aneurysm rupture with an OR 0.54 (CI 0.39-0.74). Only one article analyzed the formation of intracranial aneurysm and the use of hormone replacement therapy and oral contraceptive, and there was a protective effect with the use of these medications. oral contraceptive: OR 2.1 (CI 1.2-3.8) and hormone replacement therapy: OR 3.1 (CI 1.5-6.2).ConclusionThe use of hormone replacement therapy and oral contraceptive has a protective effect in intracranial aneurysm rupture and formation.

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