Stroke from central venous and sinus thrombosis (CVT) is remarkably more common in women, and has been related to hormonal factors (contraceptive use, pregnancy) and thrombophilia. The guidelines provide recommendations for screening, testing for prothrombotic conditions, and anticoagulation for women with CVT and a history of CVT. The overall stroke risk is low from hormonal contraception; however, certain subgroups of women may be at higher risk for stroke, including women who are older, smoke cigarettes, have hypertension, diabetes, obesity, hypercholesterolemia, and prothrombotic mutations. Additional research is needed to learn about subgroups of women at risk for hemorrhagic stroke with oral contraceptive use, with respect to age, race/ethnicity, genetics, and parity. Research should also assess the value of biomarkers of endothelial dysfunction during the course of oral contraceptive use and arterial thrombotic event. The guidelines advocate for blood pressure evaluation prior to hormonal contraceptive initiation as well as the treatment of stroke risk factors among oral contraceptive users. Oral contraceptives should not be given to women who smoke cigarettes or those with prior thromboembolic events. Studies of the association between age at menopause or premature menopause and stroke risk suggest an increased risk of stroke with earlier onset of menopause, but results are inconsistent. Additional research is necessary to fully discern the impact of onset of menopause on stroke risk. An increase in stroke risk is associated with the use of hormone therapy in standard formulations of CEE/MPA as well as the use of SERMs. Additional studies are needed to draw conclusions about long-term hormone therapy use when initiated in perimenopausal women or postmenopausal women younger than 50 years of age. Prospective randomized trials of alternate forms of hormone therapy are ongoing. 