A recent study conducted in Denmark has shed light on potential risks associated with certain hormonal contraceptives, particularly in relation to heart attacks and strokes. Although the overall risk remains low, it is crucial for healthcare providers to be aware of these findings when prescribing contraceptives to women. The study, which analysed data from over two million women aged 15 to 49, identified an increased risk of heart attacks and strokes associated with various forms of hormonal contraception including pills, IUDs, implants, injections, patches, and rings.
For women using combined oestrogen-progestin pills, the most commonly used contraceptive in the study, there was a two-fold increased risk of heart attack or stroke. Progestin-only contraceptives, such as pills and implants, also showed a slightly elevated risk, though lower than the combined pills. Non-oral combined contraceptives like the vaginal ring and patch seemed to have higher risks, with the vaginal ring linked to a 2.4-fold increased risk of stroke and a 3.8-fold increased risk of heart attack, while the patch showed a 3.4-fold increased risk in stroke.
Responding to these findings, health experts have emphasised that the absolute risks associated with hormonal contraceptives are low for the majority of women. Dr. Sonya Babu-Narayan from the British Heart Foundation highlighted that the additional risk of heart attack and stroke is minimal, equivalent to one extra heart attack per 10,000 women using hormonal contraception for a year. Dr. Becky Mawson, a clinical lecturer at the University of Sheffield, cautioned against discontinuing contraceptive use based solely on this study, noting that the risks of stroke and heart attack in pregnancy and postnatal periods are often higher.
While the types of contraceptives studied are similar between the UK and Denmark, there may be variations in specific brands and method popularity. The study’s findings, published in The BMJ, indicated that most contemporary hormonal contraceptives were associated with increased risks of arterial thrombotic events, with the exception of the levonorgestrel-releasing intrauterine device, which was deemed safer for cardiovascular health. The study also underlined the importance of considering individual risk factors and discussing contraceptive options with healthcare providers.
Therese Johansson, from the Royal Institute of Technology in Sweden, highlighted that the use of hormonal contraceptives is widespread globally, with eight out of 10 women having used them at some point. She stressed that while the risks of heart issues identified in the study are serious, they are rare in young women. Dr. Channa Jayasena, a consultant at Imperial College London, reiterated that the absolute risk of experiencing a stroke or heart attack while on the pill remains low, with the importance of lifestyle factors like smoking cessation, healthy eating, and exercise also playing a role in mitigating risks associated with hormonal contraceptives.
In conclusion, the study’s findings provide valuable insights into the potential risks of certain hormonal contraceptives in relation to heart health. While the absolute risks are low, it is essential for healthcare providers and women to have informed discussions about contraceptive options, taking into account individual health profiles and preferences. These findings underscore the need for ongoing research and dialogue surrounding women’s health and contraceptive choices to ensure the best possible outcomes for all.