Ills of pills

As birth control pills tend to increase a woman's blood pressure, women need to watch their heart health, warn Dr Brajesh Kumar Kunwar & Dr Manjiri Mehta

With widespread fear about Covid-19, heart health has been neglected. 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 calls for a relook at a woman’s reproductive well-being and the close association between the use of oral contraception and its impact on heart health. It is a well-known fact that birth control is not widely discussed, leading to a lack of awareness, which in turn impacts a woman’s health. Using oral contraceptive pills (OCP) or 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.

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 (IUD s), 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 (a form of chest pain). The formation of blood clots could be a potential risk due to the estrogen in birth control pills.

The following are the risks of heart disease and other complications if one is on oral contraceptive pills:

If you are over 35 yrs of age.

Have existing conditions of high blood pressure or high cholesterol, diabetes.

Have been a smoker.

Have a history of stroke, heart attack, or blood clots.

Experience migraines with aura.

Here’s how to lower your risk of heart disease if you are on OCPs:

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 35 yrs 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.

(Dr Brajesh Kumar Kunwar is a senior interventional cardiologist & Dr Manjiri Mehta is a senior consultant gynaecologist and obstetrician.)