Contraception and cardiovascular complications

    320 237 Τζανογιώργης Ιωάννης | Ειδικός Καρδιολόγος

      Contraception and cardiovascular complications

      The use of oral contraceptives has been a widespread contraception practice for over half a century.

      However, from the early years of its use, complications from the cardiovascular system (mainly an increase in thromboembolic risk and myocardial infarction) have been reported. The reduction in estrogen-progesterone content significantly reduced this risk.

      But what is the situation today and how real is the risk of cardiovascular complications?

      Various epidemiological studies have shown that oral contraceptive use may increase the risk of myocardial infarction. However, myocardial infarction in young, healthy women of childbearing age is extremely rare, making it safe to use contraceptives.

      However, this is not the case for women over 35, smokers. In this case smoking cessation should be recommended or another method of contraception sought.

      Another potential complication is stroke (ischemic or hemorrhagic). In this case too, the risk to young women, without risk factors, is extremely low. However, in the event of a stroke, the contraceptives cannot be reused.

      With regard to blood pressure, the use of even small doses of contraceptives shows an increased probability of arterial hypertension by 1.8 times. This risk was rapidly reduced after treatment was discontinued.

      Given that the rise in blood pressure is associated with an increased risk of stroke and stroke, regular blood pressure monitoring is recommended.

      And of course taking contraceptives affects the lipid profile, mainly by increasing triglycerides, and in some cases cholesterol, while it seems to cause mild insulin resistance.

      What data do we have about thromboembolic disease?

      Women who use combination pills (pills containing two hormones) have a four times higher risk of developing deep vein thrombosis (DVT) than those who do not use contraceptives. The risk remains for both the use of high-dose estrogen pills and those with a lower content. Age, body weight and thrombophilia affect overall risk. Another factor is the type of progesterone that the contraceptive contains. In general, preparations containing levonogestrel appear to have the smallest risk of developing DVT.

      In conclusion, oral contraceptive pills are a safe treatment as long as some basic principles are adhered to. In young, healthy women with no cardiovascular risk factors, their use has far more benefits than the potential rare side effects that may occur. Greater caution is needed when accumulating various risk factors such as smoking, obesity and older age. Rational use, regular monitoring and possibly choosing a different method of contraception are the best way to avoid complications