Heart Disease & Birth Control

Heart disease & birth control at a glance

• The estrogen in birth control pills and in hormone patches, implants, vaginal rings and injections can cause an increase in blood clotting, which could result in a heart attack. However, birth control pills are relatively safe for most women, particularly women younger than 35.
• Women who have any form of heart disease should not take hormone-based birth control methods without consulting their physician.
• Women who are at greater risk for heart attack due to age, obesity, smoking or other contributing factors should also consult their doctor about using hormone-based birth control.

The link between birth control & heart disease

The most important link between birth control pills and heart disease involves a woman’s age and her other risk factors for heart disease. The combination of age and smoking presents so strong a risk that the Food and Drug Administration says women who smoke and are 35 or older should not take combination birth control pills (containing estrogen and progestin hormones). Progestin-only birth control pills may be appropriate for women over 35 and who are smokers, but they should check with their doctor.

Birth control pills can also increase a woman’s risk of having a heart attack. However, that risk is still very small for most women, especially for those under 35 who do not have other risk factors for heart disease, such as smoking or obesity.

Chance of blood clot is the primary reason for the increase in heart attack risk. Estrogen in birth control pills, patches, implants, rings and injections can cause blood to clot easier, which can cause a heart attack if the clot blocks blood flow to the heart, or can cause a stroke if the clot blocks blood flow to the brain.

A recent major study on the risk of heart attacks for women who take birth control pills shows a 50 percent increase in risk for those taking combination birth control pills that contain an ultra-low dose of estrogen. For women who take a traditional combination pill with a low-dose of estrogen, the risk of heart attack increases by 80 percent.

Although birth control pills cause such a high increase in heart attack risk, the birth control method remains safe for most women because heart attacks among women younger than 50 are rare. Many women enter menopause around age 50 and quit taking birth control pills. Studies show that the risk of heart attack drops back to normal after a woman stops taking the pill.

Do birth control pills cause heart disease?

Birth control pills do not cause heart disease. They do tend to increase a woman’s blood pressure. If a woman has other risk factors for heart disease, taking birth control pills can compound that risk.

Can I use birth control pills if I have heart disease?

Women who have cardiovascular disease or congenital heart disease should not take birth control pills without the advice of their physician. Women with complex heart disease should not use estrogen-based birth control pills or other estrogen-based methods.

In general, if a woman has a risk factor for heart disease such as obesity, uncontrolled high blood pressure or smoking, she should consult her doctor about taking birth control pills or other estrogen-based contraceptives.

Heart disease & other forms of birth control

• Women with congenital heart disease may be able to use progestin-only birth control devices such as an implant, the Depo-Provera injection, or a patch.
• The copper-containing IUD may be a good option for women with heart disease, as it does not contain the hormones that would otherwise increase her risk.
• Birth control patches can deliver more estrogen than birth control pills, so women with any risk of heart disease should check with their doctor before using a patch.
• Women with heart disease should not use estrogen-based birth control implants, patches, injections or vaginal rings unless their physician is aware of their condition and prescribes them.