Hormone-based contraception, which is believed to be a safe and effective method of preventing pregnancy, is used by over 250 million women worldwide. A recent study, however, found that they are also linked to an increased risk of heart attack and stroke.
Compared to other studies, the Danish study that was published in The BMJ provides more accurate estimates for various products by using prescription data. The investigators found that goods containing estrogen, specifically the skin patch and vaginal ring, had the greatest risk estimations.
Given the extensive use of these drugs and the severity of these illnesses, the researchers emphasize that doctors should take these possible dangers into account when prescribing them, even though the absolute risk is still low. Additionally, several earlier studies indicated that their usage may raise the risk of ischemic stroke and heart attack, but the results were mixed. Evidence on the effects of various hormone combinations, their forms (pills, implants, injections, vaginal rings, or skin patches), and their duration of use are also lacking.
How Was The Study Conducted?
To determine if taking modern hormonal contraceptives raised the risk of first-time heart attacks and strokes in comparison to not using them, researchers examined national prescription records for almost two million Danish women between the ages of 15 and 49 from 1996 to 2021. They integrated many forms of contraception, including intrauterine devices, subcutaneous implants, progestin-only tablets, vaginal rings, patches, estrogen-progestin pills, and intramuscular injections.
Psychiatric medicine, hormone therapy, a history of blood clots, cancer, liver illness, renal disease, polycystic ovarian syndrome, endometriosis or infertility treatment, or a history of hysterectomy were all eliminated. The combined estrogen-progestin pill, the most widely used hormonal contraceptive, was linked to twice the risk of ischemic stroke and heart attack, according to the results. This means that for every 10,000 women who use the combined pill annually, there is an additional heart attack and one stroke for every 4,760 women who use it.
What is an ischemic heart attack?
Experts define ischemic heart disease as cardiac weakness brought on by decreased heart blood flow. Usually, coronary artery disease, which happens when your coronary arteries narrow, is the cause of this decreased blood flow. Ischemic cardiomyopathy and cardiac ischemia are other names for ischemic heart disease.
How do hormonal contraceptives work?
By thickening cervical mucus, weakening the uterine lining, and preventing the release of eggs from the ovaries, hormonal contraceptives can prevent conception. Additionally, these contraceptives lessen the chance of conception by thinning the uterine lining.
Which are safer contraception methods?
Progestin-only contraceptives, such as mini-pills, hormonal IUDs, and implants, are usually seen to be safer for heart health than combination tablets, according to specialists. There is no risk to heart health from non-hormonal approaches like copper IUDs and barrier techniques. The researchers believed that there could be more factors that could be increasing the risk of heart attacks and strokes that they were unaware of, but as the study was observational, it was unable to draw any firm conclusions. "Although absolute risks [of these incidents] were low," the investigators stated in the british Medical Journal, "clinicians should include the potential risk... in their assessment of the benefits and risks when prescribing hormonal contraceptive methods."
Compared to other studies, the Danish study that was published in The BMJ provides more accurate estimates for various products by using prescription data. The investigators found that goods containing estrogen, specifically the skin patch and vaginal ring, had the greatest risk estimations.
Given the extensive use of these drugs and the severity of these illnesses, the researchers emphasize that doctors should take these possible dangers into account when prescribing them, even though the absolute risk is still low. Additionally, several earlier studies indicated that their usage may raise the risk of ischemic stroke and heart attack, but the results were mixed. Evidence on the effects of various hormone combinations, their forms (pills, implants, injections, vaginal rings, or skin patches), and their duration of use are also lacking.
How Was The Study Conducted?
To determine if taking modern hormonal contraceptives raised the risk of first-time heart attacks and strokes in comparison to not using them, researchers examined national prescription records for almost two million Danish women between the ages of 15 and 49 from 1996 to 2021. They integrated many forms of contraception, including intrauterine devices, subcutaneous implants, progestin-only tablets, vaginal rings, patches, estrogen-progestin pills, and intramuscular injections.
Psychiatric medicine, hormone therapy, a history of blood clots, cancer, liver illness, renal disease, polycystic ovarian syndrome, endometriosis or infertility treatment, or a history of hysterectomy were all eliminated. The combined estrogen-progestin pill, the most widely used hormonal contraceptive, was linked to twice the risk of ischemic stroke and heart attack, according to the results. This means that for every 10,000 women who use the combined pill annually, there is an additional heart attack and one stroke for every 4,760 women who use it.
What is an ischemic heart attack?
Experts define ischemic heart disease as cardiac weakness brought on by decreased heart blood flow. Usually, coronary artery disease, which happens when your coronary arteries narrow, is the cause of this decreased blood flow. Ischemic cardiomyopathy and cardiac ischemia are other names for ischemic heart disease.
How do hormonal contraceptives work?
By thickening cervical mucus, weakening the uterine lining, and preventing the release of eggs from the ovaries, hormonal contraceptives can prevent conception. Additionally, these contraceptives lessen the chance of conception by thinning the uterine lining.
Which are safer contraception methods?
Progestin-only contraceptives, such as mini-pills, hormonal IUDs, and implants, are usually seen to be safer for heart health than combination tablets, according to specialists. There is no risk to heart health from non-hormonal approaches like copper IUDs and barrier techniques. The researchers believed that there could be more factors that could be increasing the risk of heart attacks and strokes that they were unaware of, but as the study was observational, it was unable to draw any firm conclusions. "Although absolute risks [of these incidents] were low," the investigators stated in the british Medical Journal, "clinicians should include the potential risk... in their assessment of the benefits and risks when prescribing hormonal contraceptive methods."
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