Think Birth Control Pills Are Dangerous? Try Pregnancy

Jan 15, 2009 10:19am


Since hormonal birth control first appeared in the 1960s, nearly 80 percent of women have taken it at some point in their lives. The pills and patches are so commonplace now that many of us tune out the warnings on the packaging or at the end of the commercials — something about increased risk for heart attacks, strokes and blood clots? But a new study affirms the risks are real and well worth considering, especially for certain groups of women.

Chrisandra Shufelt and C. Noel Bairey Merz, two doctors from Cedars-Sinai Medical Center, conducted a review on heart health and birth control that was published this week in the Journal of the American College of Cardiology. They found that the hormones can trigger blood clots, which in the arteries can cause heart attacks and in the brain can cause a stroke. Overall, the heart risk appeared about 2.5 times greater for women currently using hormonal birth control compared to those who were not.

The results sound very scary — birth control pills double your risk for heart attacks — but a little more context helps put the findings into perspective. First, women of child-bearing age have a low risk for serious heart disease; the risk for death from heart disease is about 0.002 percent per year for women under 35. So even if hormonal birth control doubles those odds, the risk is still quite tiny indeed.

There is even better news for those who don’t smoke. Studies suggest that the bulk of heart attacks and strokes caused by birth control occur in smokers. Some research even finds no increase in heart risk among healthy, nonsmoking women on birth control pills.

Also, if you’re looking for something that raises the risk for women’s heart problems, consider pregnancy. Studies show pregnancy is linked to a two- to three-fold increase in the odds of heart attack, an eight-fold increase in the odds of stroke, and as high as a 50-fold increase in the odds of blood clots. Hormonal birth control pills look quite safe by comparison.

But low-risk is not NO risk, and women should be aware of the effects that these pills and patches can have on their health. Women over 35, especially those who smoke or have high blood pressure, may want to consider methods of birth control that do not alter hormones, such as condoms or a diaphragm.

Women should also examine why they are taking the pills and determine if the health trade-offs are worth it. Hormonal birth control is “marketed now almost as a lifestyle drug,” Dr. Sharonne N. Hayes, director of the Mayo Clinic Women’s Heart Clinic, told ABC News. According to Hayes, more and more women are taking birth control for other conditions such as acne and mood disorders linked to menstruation. Women must decide if treating these problems with birth control is worth the increase in heart disease risk.

Finally, though the risk remains, there is some evidence to suggest that it’s decreasing with newer forms of birth control. The review by Shufelt and Bairey Merz included several articles that found lower rates of heart disease in women taking more recent formulations of the pill or the patch. The newer versions tend to use lower doses and slightly different combinations of hormones, both of which may cut down on the risk.

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