Is Heart Disease a Worry if I Use the Pill?

Medically Reviewed by Murtaza Cassoobhoy, MD on March 12, 2023
3 min read

If you take the pill or other types of birth control that have hormones -- and you're healthy and young -- you can feel comfortable that it's a safe choice to prevent pregnancy. There are some women, though, who may see their risk go up slightly for heart disease, heart attacks, strokes, and blood clots.

You may hear your doctor call the pill "hormonal" birth control. As the name suggests, it's got hormones in it, including estrogen and/or progestin. There are other methods to keep yourself from getting pregnant that also have hormones in them, like injections, IUDs (intrauterine devices), the patch, a device implanted under the skin called Nexplanon, and the vaginal ring.

Studies show the hormones in these kinds of birth control can affect your heart in many ways. They may raise your blood pressure, for instance. So if you take birth control pills, get your blood pressure checked every 6 months to make sure it stays in a healthy range. If you already have high blood pressure, talk with your doctor to see if another way to prevent pregnancy would be better for you.

Women who take certain birth control pills may see a change in some of their blood fats that play a role in heart disease. For example your levels of HDL "good" cholesterol could go down. At the same time, your triglycerides and LDL "bad" cholesterol may go up. This may cause a gradual buildup of a fatty substance called plaque inside your arteries. Over time, that can reduce or block the flow of blood to your heart and cause a heart attack or a type of chest pain called angina.

Estrogen in birth control pills can also raise your risk of blood clots.

Your chances of heart disease and other complications are higher if you:

Even if you're in one of those situations that raise your risk for heart disease, you may still be able to use birth control with hormones. The most important thing you can do is talk with your doctor. They'll help you weigh the pros and cons of your different options.

For example, research shows that women with medical conditions such as high blood pressure and diabetes, as long as they're well controlled, may be able to safely take birth control pills.

If you're over 35, healthy, and don't smoke, you can keep using hormonal birth control.

You shouldn't use birth control with estrogen if you have ever had blood clots, a stroke, or heart disease. Instead, check out methods that only have progestin. These include shots, a type of birth control pill called the minipill, hormonal implants, and IUDs.

Women with congenital heart disease may be able to use most forms of birth control. Research suggests that progestin-only options as well as IUDs may be safest for you. Get your doctor's advice. A bonus is that IUDs and implants are the most effective forms of birth control. They are long-lasting, easily reversible and require nothing to do after being placed, making them excellent options

No matter your age, if you use birth control pills, don't smoke. The combo raises your risk for blood clots and heart disease.