For women living with heart disease, being of reproductive age comes with its own set of challenges. Whether you are choosing to delay pregnancy, are done having children, or have been advised against pregnancy due to your heart health, choosing a method of birth control that works for your needs is essential.
Finding the right birth control method is not just about personal preferences, potential side effects, and affordability; your heart health also needs to be taken into consideration. Learning more about available contraceptive methods and having conversations with your healthcare team about what may work best for you, is key to finding an effective, safe, and compatible birth control option that puts your overall well-being first. By exploring the available choices to understand the risks associated with certain heart conditions, you can confidently navigate your birth control journey.
Let’s start by acknowledging that abstinence, barrier methods, and fertility-awareness methods (i.e., the rhythm method), are all ways people may choose to reduce the chance of pregnancy. However, it’s important to keep in mind that these methods all involve a high level of work and commitment to be consistent to ensure that you are using them correctly and, even then, may still result in unintended pregnancies. While certain barrier methods—such as condoms—are essential in keeping you healthy when there is a risk of sexually transmitted diseases (STDs), they alone are not as effective at preventing pregnancy as the following methods.
Short-Acting Hormonal Methods: What You Need to Know
Hormonal birth control methods, such as the pill, patch, or vaginal ring, are popular options. These are considered short-acting because they require you to take them regularly. While highly effective if used as directed, the failure rate can vary and is most often based on user error.
Some of these hormonal methods (i.e., combined oral contraceptives, the patch, and the vaginal ring) include a combination of synthetic estrogen and progestin to help prevent pregnancy. However, these methods are also associated with a higher risk of blood clots and may also raise blood pressure, particularly in smokers over the age of 35. If you already have a history of blood clots, pulmonary hypertension, heart attack or stroke, or uncontrolled high blood pressure, estrogen-containing methods should be approached with caution as this type of birth control may negatively impact your heart health. On the other hand, progestin-only options, like the “mini-pill” or the shot, have not been associated with these risks.
LARC and Permanent Options: Long-Term Reliability
Long-acting reversible contraception (LARCs), such as intra-uterine devices (IUDs) and the implant, provide long-term efficacy ranging from 3 to 10 years. Most LARCs are not associated with an increased risk of blood clotting as they don’t contain estrogen. For those who prefer to avoid hormonal methods altogether, non-hormonal copper IUDs are another alternative that is also highly effective. More permanent options, such as tubal ligation, are also available for those who no longer want to have children or have been advised against pregnancy due to the potential health risks.
Emergency Contraception: Just in Case
Emergency contraception (EC) is another option available in case of unprotected intercourse or birth control failure. EC pills, considered safe for women with heart disease, can be obtained without a prescription. Another option is the copper IUD, which can be inserted within seven days of unprotected intercourse and is highly effective at preventing pregnancy. However, a medical visit is required in order to have the IUD inserted.
Navigating Your Choices
Although the decision-making process may feel overwhelming, remember to consult with your medical team, who is there to guide and support you. Share your preferences and concerns with your healthcare provider to find the best birth control method for you. It may take some trial and error, but with a range of options available, you can make informed decisions that prioritize both your reproductive health and cardiovascular well-being. Rest assured, you’ve got choices, and together with your medical team, you can find the one that suits you best. To gain more insight on the contraceptive methods currently available and how they may interact with your heart health, take a look at our HeartTalk on Heart Disease and Birth Control.