Contraception and a heart condition

Image of different types of contraception

If you have a heart condition, some types of contraception may suit you better than others.

Here we explain why the choice is important and lay out some options for you.

Heart conditions and pregnancy

Pregnancy puts a strain on the heart. This is because of changes that affect the heart and blood vessels which are vital in supplying a growing baby with enough oxygen and nutrients. These changes are hard work for the body, even for women without a heart condition. If you have a heart condition, these changes can put even more strain on your body.

Some heart conditions can put you at a higher risk of developing blood clots in your body, which can increase your risk of a having a stroke. If you have one of these conditions, such as atrial fibrillation or you have a mechanical heart valve, recommendations for contraception may vary. 

If you have a heart condition and become pregnant unexpectedly, it’s important to visit your doctor as soon as possible. This will allow them to review your medications and refer you on to a specialist if necessary, to discuss your options and to help make sure you have as healthy and safe a pregnancy as possible.

Types of contraception and how they work

Many types of contraception are available to plan or prevent a pregnancy. They work in different ways and suit different people at different times in their life. For every type of contraception, you should consider how safe it is for your heart, and how effective it is in preventing pregnancy.

If you want to start or stop your contraception we recommend that you talk to your doctor. Depending on your circumstances and your heart condition, they may want to monitor you. 

No type of contraception is 100 per cent effective in preventing pregnancy. However, some are more effective than others. 

Natural Methods 

This involves being aware of your menstrual cycle and using it to plan or avoid pregnancy. While it works for some people, this method needs to be followed very carefully to avoid pregnancy. For this reason, it’s not recommended for women with a heart condition. 

Barrier Methods

Male and female condoms are safe for all users and are the only type of contraception that protects against sexually transmitted infections. 

Pills 

There are two types of contraceptive pill - the combined pill containing the hormones oestrogen and progesterone, and the progesterone-only pill.

The combined contraceptive pill can slightly increase your risk of high blood pressure and blood clotting problems so it’s important to be checked on a regular basis.

Problems with blood clotting can increase your risk of deep vein thrombosis (DVT). This increases the risk of pulmonary embolism, where a blood clot moves up into your lungs and blocks the flow of blood. A pulmonary embolism is a life-threatening and needs emergency treatment. 

If you have a heart condition that makes you more likely to develop blood clots or you have high blood pressure then types of contraception  that contain oestrogen are very unlikely to be recommended by your doctor. 

Implant 

The implant is a small rod implanted just under your skin in your upper arm. It contains the hormone progesterone and is thought to be safe for most women with a heart condition

IUD (Intra-uterine Device)

This is a small ‘T’ shaped device that is inserted into the uterus. For some women with heart conditions, you may be advised to have an IUD implanted within a hospital environment with cardiac monitoring, as these devices can cause fainting when implanted. 

Insertion of an IUD carries a risk of infection. So depending on your heart condition, your doctor might recommend you take antibiotics after having your IUD implanted. 

Post-coital Contraception (Emergency) ‘morning after pill’

Two progesterone-only pills are available as emergency contraception. They’re not known to affect the heart and so are thought to be safe for most women with a heart condition. 

Sterilisation

Sterilisation is a permanent method of contraception and involves surgery. If you’ve decided that you never want to have a baby or another child then this is an option.

Having an operation is usually slightly higher risk if you have a heart condition. The procedure is usually performed under general anaesthetic which may be a risk in itself depending on your heart condition. You will need to check this with your doctor before your surgery.

Further information and useful contacts

For more information on what contraception might be right for you please contact your GP, local family planning clinic or speak to the specialist managing your condition.

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