More than a month after Hailey Bieber shared that she was hospitalized after suffering "stroke-like symptoms," the model has opened up about her experience with what doctors determined to be a transient ischemic attack (TIA), often called a ministroke.
In a YouTube video posted Wednesday, Bieber listed the factors that likely led to the mini-stroke: her recent COVID-19 infection, a long flight from Paris to Los Angeles, a hole in her heart and taking birth control pills in combination with her history of migraines.
“COVID-19 does increase risk for stroke, particularly in the first month after you’ve had it,” Dr. Gayatri Devi, a neurologist at Northwell Health in New York City, said on TODAY Thursday. “But after that, it goes back to normal.”
As for the flight, Devi said it could’ve increased her risk “because you’re in a stationary position, and that’s more likely to cause blood clots in your legs, which can then travel up to your brain.”
The hole in Bieber's heart, which doctors have since closed up, was “definitely a contributing factor,” as well, Devi said. She called it a patent foramen ovale, or a small opening between the two upper chambers of the heart, which usually closes up shortly after birth. If it doesn't, then there's a greater risk of stroke, per Johns Hopkins.
Devi confirmed the birth control may also have been a contributing factor to Bieber's TIA because of her medical history. Bieber, 25, said she did not consult her doctor prior to taking the pills.
Can birth control lead to a stroke?
It's true that "birth control (and) migraines that have auras — in other words, flashing lights or neurologic symptoms — can increase the risk” of stroke for women," Devi said.
In fact, a history of migraines with aura are a "contraindication" for prescribing birth control bills, meaning that usually they won't be prescribed for such patients, said Dr. Christine Greves, an OB-GYN at Orlando Health Winnie Palmer Hospital for Women & Babies.
She added that "if you're over 35 and have migraines, period, you should not be on birth control."
It's not clear why a history of migraines may increase one's risk of stroke, but there is an association between the two, Greves said.
While Bieber's recent hospitalization may seem scary to the millions of women on birth control pills, Greves stressed that there's no need to worry if you're taking the correct precautions.
This means always talking to your health care provider before starting a new birth control pill and another visit one to two months later. You should also discuss your birth control regimen at every annual physical because, overtime, birth control may increase your blood pressure, which can increase your risk of heart issues.
"The whole reason this made the news is it's not that common," Greves said, adding that there's "a very low likelihood" that someone on birth control pills with no stroke risk factors will experience a stroke. "But it's still possible, which is why we talk about it."
In addition to staying up to date on health care visits, Greves advised people taking oral contraceptive pills keep their cholesterol and blood pressure in the normal range, be active and not smoke as ways to maintain their heart health and reduce stroke risk.
What should you do if you have a stroke?
“If you’re having a stroke, think of it as a brain attack and call 9-1-1,” Devi urged. “Treat it like you would a heart attack, because you only have a few minutes to make a difference. Within the first few hours, doctors now can basically dissolve the stroke and recover function.”
If symptoms pass before you're able to call 911, you should still call.
“You should still go (to the hospital) because that could be a warning symptom, a clot that’s there that got dissolved,” she said. “Another clot could happen.”
Last month, NBC News medical contributor Dr. Natalie Azar shared with TODAY how to spot early stroke warning signs.
"The easiest way to remember the signs and symptoms of a stroke are with the acronym FAST," she said. If there's facial drooping, arm weakness or speech problems, then it's time to act.