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World Heart Day

The Risk of Heart Disease from Oral Contraceptive Pills

 By Dr Brajesh Kumar Kunwar, Senior Interventional Cardiologist & Dr Manjiri Mehta, Senior Consultant Gynaecologist and Obstetrician, Hiranandani Hospital, Vashi-A Fortis Associate

The burden of cardiac conditions is on an increase; with widespread fear about COVID19, heart health is not being paid attention to. When it comes to diseases of the heart, both men and women are at the receiving end. Women are susceptible to a number of health issues. And in India each year, more women are dying of heart disease as compared to men-which is often overlooked! This World Heart Day 2020, observed on the 29th of September, let’s look at a woman’s reproductive well-being; and the close association between the use of oral contraception and its impact on heart health.

Dr Manjiri Mehta

 It is a well-known fact that birth control is not widely discussed, leading to lack of awareness, which in return impact a woman’s health. Using Oral Contraceptive Pill (OCP) or different other birth control measures which contain hormones is the preferred and safe method in preventing pregnancy. However, some women may be at a higher risk of heart related diseases, Heart Attacks or Strokes as well as blood clots. It is imperative to be prescribed birth control measures by your physician only, avoiding self- prescription is imperative. This will enable women to discuss the pros and cons with their physician, and effectively manage their health.

Dr Brajesh Kunwar

 How can oral contraceptive pills raise heart risk?

Known as the ‘hormonal birth control measure’ by doctors; hormones Estrogen and Progestin are essential components of a pill. Other forms of pregnancy control which include injections, patches, Intrauterine Devices (IUDs), Vaginal Rings and Nexplanon-which is a device implanted under the skin, all contain the two hormones.

 As per studies, the Heart may be affected in various ways due to the hormones found in these forms of pregnancy control measures. For instance, your blood pressure could increase; so it is important to get your blood pressure checked every six months if you take these pills in order for the blood pressure to stay in a healthy range. You may also consult your doctor about other safer ways to control your blood pressure and prevent pregnancy, both options that would suit you better. Taking certain birth control pills may cause a change in some of your blood fats that contribute to Heart Disease. An example as such is the levels of HDL (or good cholesterol could) decrease and at the same time Triglycerides/ LDL (or bad cholesterol) may increase. This could lead to a build-up of Plaque (fatty substance) inside your Arteries and over a course of time, reduce or block blood flow to your Heart, causing a Heart Attack or Angina (form of chest pain). The formation of blood clots could be a potential risk due to the Estrogen in birth control pills.

Risk of heart disease and other complications is higher when on OCP, if you:

·        Are over 35yrs of age

·        Have existing conditions of High Blood Pressure or High Cholesterol, Diabetes

·        Are a smoker

·        Have a history of Stroke, Heart Attack, or Blood Clots

·        Experience Migraines with aura                               

Lowering risk of heart disease when on OCP:

You may still be able to use birth control if you are at a risk of Heart Disease even if you fall under the categories listed above. What is imperative is that you must discuss all your concerns with your doctor.  They will assist in weighing the pros and cons, against each birth control option, offered to you. 

For example, those women with existing medical conditions such as high Blood Pressure and Diabetes may be able to safely take birth control pills if the said conditions are kept under control. You may continue using hormonal birth control if you are over 35yrs and healthy and a non-smoker. However, if you have ever experienced Blood Clots, Stroke, or Heart Disease, do not use birth control with Estrogen. As an alternative, consult your doctor about pregnancy control methods that only contain Progestin. These include shots, a type of birth control pill called the mini pill or POP, Nexplanon, and Intrauterine Devices (IUDs). For women with congenital heart disease, using most forms of birth control is permissible. As per research, Progestin-only options as well as IUDs is the safest option. 

Your doctor will be the best confidant for you to make the best choice!

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