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Birth Control and High Blood Pressure: What to Know

Medically Reviewed by Nivin Todd, MD on June 21, 2022

If you have high blood pressure or are worried about getting it, you may wonder if hormonal forms of birth control should be avoided. The answer is: not necessarily. It depends on your overall health. Certain forms may be OK if you take precautions. Talk to your doctor. Together, you can decide what’s best for you.

What’s the Link Between Blood Pressure and Birth Control?

Birth control methods that contain synthetic estrogen may raise your blood pressure. These are:

Research suggests that higher-dose birth control pills might increase blood pressure, while lower-dose pills may have less impact.

The vaginal ring and hormonal skin patch may have less effect on blood pressure, but more research is needed to know for sure. Currently, the risks are thought to be about the same as combination hormonal birth control pills.

There’s one exception: the hormone drospirenone. That’s a progestin in combination birth control pills that may slightly lower blood pressure. Experts think this is because drospirenone acts as a diuretic (a drug that makes you pee more), which may curb estrogen’s tendency to raise blood pressure.

Most people whose blood pressure goes up on the pill see it return to normal within about 3 months of stopping.

Which Birth Control Methods Don’t Contain Estrogen?

Estrogen-free forms of hormonal birth control contain progestin. These are:

  • Implants
  • Intrauterine devices (IUDs)
  • Depot medroxyprogesterone acetate (DMPA) injections
  • Progestin-only pills

What’s the Best Birth Control if You Have High Blood Pressure?

It depends partly on your age. If you’re 35 years old or younger and your blood pressure is well-controlled, options considered safe include:

Nonhormonal barrier methods like the first four are less likely to raise your blood pressure or risk of heart disease, but it’s important to keep in mind that they also have a higher failure rate, too. You’ll need to balance the risks of an unplanned pregnancy with your high blood pressure.

If you’re not happy with any of the above methods, and your blood pressure is well-controlled, you can try an estrogen-containing birth control pill that has less than 35 mcg of estrogen or the hormone shot. But you’ll have to check your blood pressure 2 to 4 weeks after you start the birth control pill, and stop if it rises.

If you’re older than 35 with well-controlled blood pressure, it’s also safe to use any of the eight above options. If you don’t like any of them, you can try the shot with caution, but you’ll need to avoid estrogen containing oral contraceptives.

If your blood pressure is uncontrolled (at or over 160/100), then it’s best to stick to nonhormonal options no matter your age. Although, the hormonal IUD, implant, and progestin only birth control pills could be used with caution.

Show Sources

SOURCES:

JAMA: “Hormonal Contraception in Women with Hypertension.”

UpToDate: “Contraception: Hormonal Contraception and Blood Pressure,” “Etonogestrel Contraceptive Implant,” “Depot medroxyprogesterone acetate (DMPA): Efficacy, side effects, metabolic impact, and benefits.”

Harvard Health Blog: “Birth control and high blood pressure: Which methods are safe for you?.”

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