Birth Control Pills And High Blood Pressure
Do Oral Contraceptives Cause Elevated Blood Pressure?

preventing pregnancy


Oral Contraceptive Pills And Blood Pressure


Does The Contraceptive Pill Cause High Blood Pressure?
Who Should Avoid The Pill?
What If My Blood Pressure Goes Up?
Blood Clots And The Pill
How The Pill Has Developed

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Guide To Hypertension

Does The Contraceptive Pill Cause High Blood Pressure?

Yes, contraceptive pills do slightly increase your blood pressure. This is why your doctor will always check your blood pressure reading when you renew your prescription. However, for most healthy women who are neither obese nor smokers, the rise is negligible. There used to be a debate for many years whether or not it was safe for women to continue taking the Pill into their 30s and 40s because it was thought the risk of complications was greater after 35. Today, due to feedback from clinical trials, most doctors now believe it is safe to continue taking the Pill throughout the perimenopause years right up until menopause (is it safe to take the contraceptive pill after 35?). However, if you are receiving treatment for high blood pressure (hypertension), you will need to talk to your doctor about whether you should use a safer method of contraception like condoms.

Who Should Avoid The Pill?

Most doctors will advise you not to take the pill if:

1. If you have hypertension or there is a history of heart disease in your family.
2. You experienced hypertension during pregnancy.
3. You are obese. Women with a body mass index (BMI) of over 30 have double the risk of developing rare blood clots on the Pill.
4. You smoke, particularly more than 15 cigarettes a day. In particular, smokers should never take the Pill after the age of 35. It increases their stroke and heart attack risk factors.
5. You are diabetic. Although the jury is still out on this, it appears that the Pill might interfere with blood sugar levels. If you have diabetes you may need to take a higher dose of insulin or oral diabetes medications.
6. Migraines. The American Congress of Obstetricians and Gynecologists (ACOG) recommends against taking oral birth control pills if you suffer migraines because the combination raises your stroke risk factors nearly 3-fold.
7. You have high cholesterol, in particular 'bad' LDL cholesterol levels of over 160 mg/dL.
8. You take epilepsy medications, the Pill has a slightly higher risk of failure due to drug interactions.

What If My Blood Pressure Goes Up?

If you start taking the birth control pill and your blood pressure increases, your doctor will monitor you closely. The following options will be considered:

1. Continue taking the pill and wait to see if your levels go back down again. You may even consider buying a home blood pressure monitor.
2. Switch to a different pill with lower levels of progesterone.
3. If your levels remain high you will need to stop taking oral pills. If this happens your doctor will talk to you about alternative contraception. Usually the options in this instance are:

1. Condoms: Although less convenient, condoms they have the added bonus of protecting you from sexually transmitted diseases. This is also true of the female condom, a newer addition to the contraceptive family.
2. Mirena IUD: A small IUD device which is implanted in the womb and emits miniscule doses of hormones for up to 5 years. Downside: It is only usually given to women who have already had one child.
3. Depo Provera Injection: A progesterone only birth control injection that is injected every 3 months. Downside: It involves needles!
4. Implants: The size of a matchstick, a birth control implant is inserted discreetly under the skin in the upper arm. It gradually releases small doses of progestin and lasts about 3 years.

Blood Clots And The Pill

All birth control pills are associated with the risk of blood clots, but the risk is extremely low. It was thought that the newer generation of pills which contain the hormone drospirenone would lower this risk even further (early studies funded by the birth control industry indicated this). But a new study carried out in Israel on 330,000 women casts doubt on this claim. It found that popular brand names like Yasmin and Yaz birth control pills, which contain drospirenone, are MORE likely to cause blood clots than the older generation pills. In fact, the risk of clots (technically called venos thromboembolisms) was nearly 65 percent higher. Just so we don't cause any panic, this still only translates to 8 to 10 incidences per 10,000 women every year. That said, clots are highly dangerous, they usually occur in the veins of the leg, but can travel to the lungs where they can lead to a life threatening condition called a pulmonary embolism. For this reason, women who have received a hypertension diagnosis, or are obese or smoke (highest risk factors for blood clots) should avoid taking all oral contraceptives. Prompted by the findings from the Israeli study, the FDA carried out its own research. They found that based on the records of 800,000 American women between 2001 to 2007, the risk of clots was higher in drospirenone-containing pills. They said this translated to 10 cases per 100,000 women compared to the older Pills which were 6 per 100,000.
Bottom Line: If you have been using Yaz or Yasmin for some time without any problems, there is no reason to switch to another brand. Weighing the risks and side effects, one brand of birth control pill is not particularly more 'dangerous' than another. Of course, it never hurts to introduce hypertension prevention lifestyle tips into your daily regime.

Related Topics

Curious about the causes of high blood pressure? Or would you like to read about the symptoms of hypertension?
Worried you'll gain weight if you take the Pill?
Will I gain weight on the contraceptive pill?
Worried about the risk of falling pregnant on the Pill?
Can you get pregnant while taking the Pill?
Information about the morning after pill:
What is emergency contraception?
Comparing birth control pills and emergency contraception:
What is the difference between the emergency contraception pill and the normal pill?

How The Pill Has Developed

Over the years as improvements are made in the birth control pill, older types of pills are sent into retirement. The different 'generations' of Pills basically vary by which type of progestin they use - progestin is a man-made version of the hormone progesterone. Second generation Pills contained progestins called norgestrel or levonorgestrel. However they tended to produce unwanted side effects like excess body hair and acne outbreaks. The third generation of progestins created in the 1980s were developed to reduce these effects. While they did this, some studies later found that they carried a higher risk of blood clots than the previous generation. About 10 years later, Yasmin was launched by Bayer Healthcare on the market, containing yet another new progestin called drospirenone. Not only did it seem to cause fewer cases of blood clots (now debatable) but it also caused less weight gain and water retention than earlier pills. It also seemed to reduce the symptoms of premenstrual dysphoric disorder (a severe form of PMS). In 2006 Bayer launched other new brands containing drospirenone called Yaz and Beyaz - which quickly became the top selling birth control pills in the United States.

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