Discussing Birth Control with your doctor is important if you have heart disease because some forms of birth control may not be safe.
Things to consider when choosing birth control
If you have a heart condition, you should discuss birth control with your heart specialist (cardiologist) to find out which kinds of birth control are best for you. When deciding upon the best form of birth control for you, you will need to consider the following:
1) Your risk of heart-related complications during pregnancy
2) The risks and benefits of available types of birth control
3) The failure rates of various forms of birth control
4) Your personal preferences
Every person’s heart condition is different and therefore the safety of various forms of birth control differs too. You should discuss your specific condition with your heart specialist.
Different types of birth control
Barrier methods
Barrier methods refer to condoms, diaphragms and cervical caps. These are safe for women with heart disease, but failure rates can be high. If you have a serious heart condition and pregnancy is dangerous, then these forms of birth control are not recommended because of the high failure rates.
Combined (estrogen/progestin) forms of birth control
Contraceptives (birth control) containing estrogen and progestin are called “combined” contraceptives. They come in many forms including pills (standard birth control pills), patches (EVRA®) or vaginal rings (NuvaRing®). They work well, but estrogen can contribute to blood clots and this can be dangerous for some women with heart disease. Because of the potential for blood clots, this type of birth control should not be used in women who have older style metal heart valves (Bjork Shiley or Starr Edwards), Fontan operations, cyanotic heart disease, or a history of blood clots. It can be also be problematic in women with some types of arrhythmias.
Progestin only forms of birth control
Progestin only birth control comes in many forms including pills (“mini-pill), injectable forms (Depo-Provera® or Depo-SubQ Provera®), and as implants (Implanon®). Progestin does not cause blood clots and therefore is safe for many women with heart disease. However, the progestin only pill has higher failure rates than combined contraceptive pills. If you have a serious heart condition and pregnancy is dangerous, then these forms of birth control are not recommended because of the high failure rates. Some of the newer progestin only pills are associated with lower failure rates.
Intrauterine devices (IUD)
There are two commonly used IUD; the copper IUD and the progesterone-releasing IUD (Mirena®). In general, IUD are safe for many women with heart disease. IUDs alone are not recommended if you are at risk of sexually transmitted diseases (STDs), but can be used together with condoms. This provides protection against STDs as well as very effective birth control.
Emergency Contraception
In general, emergency contraception ('the morning after pill') is safe for women with heart disease.
