-- Question: As A 30-Year-Old Woman, Should I Be Concerned About Taking Oral Contraceptive Pills And Is There Any Risk For Heart Disease With These Pills?
Answer: Oral contraceptives are some of the most effective birth control methods. And so, if you have chosen to be on oral contraceptives, presumably you're trying to prevent pregnancy. Where oral contraceptives got a bad rap, in a sense, was the first generation of oral contraceptives, which were 10 to 20 times higher doses of estrogen and progesterone than currently available oral contraceptives. So the oral contraceptives we're using today are much safer.
That said, even today's oral contraceptives, many of them can slightly increase blood pressure, they can adversely affect your cholesterol -- particularly by lowering the good cholesterol -- and they can slightly increase the risk of blood clots. So all of these things need to be taken into consideration.
There is no evidence that taking oral contraceptives today increases your risk of having a heart attack down the road after you stopped it as an older person. So that's very reassuring. If you choose to be on oral contraceptives, because that's the best method, one thing you should know, is that the risk, the cardiac risk of going through a completed pregnancy is actually much higher than taking oral contraceptives. So that's important to compare those risks. Taking care of yourself and reducing your cardiac risk factors, making sure your blood pressure is under control after you start, is a good way to reduce that risk.
The other thing is there are a number of newer oral contraceptives, and ones in development, that may actually reduce cardiac risk. Several that contain drospironone, which actually can lower blood pressure and has some other beneficial effects, are available now.
And so, we recommend you take the lowest dose for the time that you need it for oral contraception, but the cardiac risk shouldn't weigh too heavily when you make that decision.