- New research suggests certain hormonal contraceptives may increase heart attack and stroke risks.
- The vaginal ring and skin patch were associated with the highest risk, but the absolute risk remains low.
- Smoking and certain health conditions can put females at a higher risk of cardiovascular issues linked to hormonal contraceptives.
- Discussing the pros and cons of hormonal birth control with your doctor can help inform your decision about which contraceptive method is best for you.
New research suggests certain types of hormonal contraceptives are linked to a higher risk of heart attack and stroke.
Estrogen-containing contraceptives — especially the vaginal ring and skin patch — had the highest risk, according to the study findings, which were published on February 12 in The BMJ.
However, the group of Danish researchers emphasized that the absolute risk was still low. They recommend physicians consider the risks of hormonal birth control to make informed decisions for patients.
Birth control ring, patch linked to higher cardiovascular risk
Hormonal contraception is available in combined forms, including both estrogen and progestin, such as:
There are also progestin-only forms such as “mini” pills, injections, implants, and hormonal IUDs.
While previous studies have shown hormonal birth control could raise heart attack and stroke risk, not much was known about the risks associated with these individual formulations.
To answer this question, a team of researchers examined prescription records for over 2 million Danish females ages 15 to 49. Their goal was to determine whether subjects had a greater risk for heart attack or ischemic stroke (caused by blockages in the brain’s blood supply) compared to females who did not use hormonal contraceptives.
Various types of hormonal contraception in both combined and progestin-only forms were examined.
Exclusion criteria for the study included medical conditions such as:
- blood clots
- cancer
- liver disease
- kidney disease
- polycystic ovary syndrome (PCOS)
- endometriosis
- infertility treatment
- psychiatric medication use
- hormone therapy
- hysterectomy
The researchers looked for cases of either heart attack or ischemic stroke among eligible female participants. Age, education, and pre-existing conditions like hypertension and diabetes were further factored in.
They found that combined estrogen-progestin birth control pills were linked to twice the risk of stroke and heart attack.
This would mean that, out of every 4,760 females, there would be one additional stroke if females used the pill for one year. Additionally, there would be one more heart attack for every 10,000 females after one year.
Among progestin-only contraceptives, the risk was somewhat higher but lower than that for the combined pills.
The vaginal ring and patch had higher risks, with the vaginal ring being linked to a 2.4 times greater risk for stroke and a 3.8 times greater risk for heart attack.
The patch was associated with a 3.4 times greater risk for stroke.
However, it was found that the progestin-only IUD was not linked to increased risk.
It should be noted that this was an observational study, meaning the cause and effect could not be established.
What to know about hormonal birth control
The American Heart Association (AHA) states that hormonal birth control is currently safe for healthy young females.
Still, Bradley Serwer, MD, an interventional cardiologist and chief medical officer at VitalSolution, a cardiovascular and anesthesiology service, said weighing the risks against the benefits is important.
“If someone is high risk for complications, they may want to consider a safer option,” he told Healthline. Serwer wasn’t involved in the new study.
Serwer added that certain groups of people are known to be at increased risk of complications from hormonal birth control.
“These groups include those that smoke, have pre-existing blood clotting disorders, those with a history of migraines, those with known cardiovascular and peripheral vascular disease, those with obesity, and those with diabetes,” he explained.
Serwer echoed the sentiments of the study authors, highlighting that the absolute risk of hormonal birth control is still very low.
“As a medical professional, we need to sit down with our patients and help them weigh the risks and benefits so that an informed decision can be made,” he said.
Ask your doctor about birth control risks
Gowri Reddy Rocco, MD, founder and president at Optimum Wellness & Longevity, agreed that any concerns over risks associated with hormonal birth control should be addressed with your primary doctor or OB-GYN. Rocco wasn’t involved in the new study.
“Certain studies have shown that IUDs may be safer with regards to blood clotting, but other studies have shown an increased risk for pelvic infections depending on the individual patient’s lifestyle,” she told Healthline.
Rocco noted that condoms could be “a reasonable choice.” However, they should be avoided if you have a latex allergy.
Other forms of nonhormonal birth control include options such as:
- diaphragms
- sponges
- cervical caps
- spermicides
- contraceptive gels
- fertility awareness
- abstinence
- tubal ligation (having your “tubes tied”)
- vasectomy
Still, certain nonhormonal birth control methods may have their disadvantages. Their effectiveness is variable and may not be as high as hormonal birth control.
Additionally, nonhormonal birth control may require a greater commitment to consistent and proper use. Certain forms of nonhormonal birth control can be quite costly, such as tubal ligation, which is also difficult to reverse.
There may be certain risks depending on what form of nonhormonal birth control you’re using, such as:
- allergy
- irritation
- urinary tract infections (UTIs)
- toxic shock syndrome
“The goal of medical professionals is to have an educated discussion with their patients and help them make the best decisions that best suit their needs while minimizing risk,” Rocco said.
Takeaway
A new study confirms previous findings that hormonal birth control is associated with an increased risk for heart attack and stroke.
The vaginal ring and the patch were especially linked with higher risk for heart attack and stroke. On the other hand, the progestin-only IUD was not associated with higher risk.
It is important to note, however, that absolute risk remains small. Hormonal contraceptives are considered to be safe for young, healthy females.
Smokers and those with cardiovascular disease, blood clotting disorders, migraine headaches, obesity, and diabetes may be advised to use alternative birth control methods.
Those concerned about risks associated with birth control should weigh the pros and cons with their doctor to find the best solution for their individual needs.
Hormonal Birth Control Linked to Heart Attack and Stroke, but Overall Risk Is Low
Source: Pinoy Lang Sakalam
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