These Are The Birth Control Options You Can Use If You Have High Blood Pressure
You've probably heard that birth control pills and high blood pressure don't mix, but that doesn’t mean you need to swear off birth control entirely. High blood pressure happens, and it happens a lot: One in three American adults struggles with the condition, according to data from the Centers for Disease Control and Prevention. If you have high blood pressure (aka hypertension), your doctor has probably recommended you make certain lifestyle tweaks and may have even put you on medication for your condition. They may have also told you that you can't be on birth control, which isn't entirely true.
“It’s not a one size fits all kind of thing—different forms of birth control have different effects on blood pressure,” cardiologist Nicole Weinberg, M.D., tells SELF.
If you have high blood pressure, it’s best to have a conversation with your doctor about the best form of contraception for you. But here are a few things you should know in advance:
Estrogen is the main concern.
There are certain types of birth control that people with hypertension should avoid, and they largely center around “combined” hormone methods, i.e. those that contain the hormones estrogen and progesterone, Kristina Tocce, M.D., a contraception researcher and ob/gyn at the University of Colorado School of Medicine, tells SELF. “Most birth control pills are likely an estrogen and progesterone pill,” she says. “But the estrogen component is the issue.”
With combined birth control pills, people can see a slight increase in blood pressure due to the estrogen. While that’s not really a big deal if you have low or normal blood pressure, for those with high blood pressure, it has the potential to be dangerous, putting patients at a higher risk of serious complications like stroke and heart disease, Fahimeh Sasan, D.O., assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai, tells SELF. “The key is for your gynecologist and primary care doctor or cardiologist to be in communication with each other,” she says.
And birth control pills aren't the only estrogen-containing methods you need to avoid, Michelle Isley, M.D., an ob/gyn at The Ohio State University Wexner Medical Center, tells SELF. The birth control patch and the vaginal ring should also be avoided if you have high blood pressure.
So, obviously, that means you need to actually know your blood pressure.
You want to do that for your health anyway, but your doctor is also going to take your blood pressure before prescribing birth control. And if it's elevated, they'll want to make sure you’re taking steps to try to lower it, Dr. Isley says. If your blood pressure is under control but you still have a history of hypertension, it’s important to flag that for your doctor, too.
Progesterone-only or non-hormonal methods are your best bet.
It’s easy to hear that you shouldn’t use certain birth control methods and then assume that you’re not left with good options, but Dr. Isley stresses that there are several great, really effective choices available if you have hypertension.
The CDC has a summary chart that tells you which methods are recommended (or not) for anyone with a certain health condition—including hypertension. Based on their data, here are the options that you can still use if you have high blood pressure (of course, there are various other factors to keep in mind before choosing a birth control method, but this might help you jumpstart the conversation with your doctor):
The IUD: There’s been a lot of hype recently about IUDs, and with good reason: These little T-shaped devices, which go into your uterus, are over 99 percent effective and you basically don't have to think about them once you get them inserted. The copper IUD lasts up to 10 years, and is hormone-free, so it's safe for someone with high blood pressure. The hormonal IUDs can work anywhere from three to five years, depending on the type you get, and they release the hormone levonorgestrel (a type of progestin, which is a synthetic version of progesterone), so there's no estrogen to worry about.
The implant: The implant is a tiny matchstick-sized rod that’s inserted into your arm, where it protects you from pregnancy for up to three years by releasing a type of progestin (not estrogen). It’s over 99.9 percent effective, making it technically the most effective method out there.
The shot: The birth control shot is an injection you get once every three months that contains progestin. The shot is more than 99 percent effective with perfect use (94 percent if you also factor in imperfect use, like not getting the shot on time). Worth noting: if you have a systolic blood pressure (the top number in your blood pressure reading) that’s 160 or higher or diastolic blood pressure (the bottom number in your blood pressure reading) that’s 100 or higher, the CDC does not recommend this method.
The mini pill: The mini pill is a progestin-only pill, so it's safe for anyone with high blood pressure. But unlike combined birth control pills, the mini pill has to be taken at the same time every day for maximum effectiveness.
Condoms: Obviously condoms are estrogen free, whether you're using a male condom or a female one. Plus, they're the only contraception that also protects against STIs.
It’s worth pointing out that the CDC leaves more options open to you if your blood pressure is “adequately controlled” but Dr. Tocce says it’s really best to play it safe. “I really don’t see why you would take that risk because there are so many methods that are effective and completely safe for people with hypertension,” she says.