Contraception and a heart condition

Contraceptive pills

If you have a heart condition, some types of contraception may be more suitable than others. There are many different forms of contraception, so if one isn’t working for you, speak to your healthcare professional about trying an alternative. 

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

 

Types of contraception and how they work

Many types of contraception are available to plan or prevent a pregnancy. Some types of contraception also prevent sexually transmitted infections (STIs). 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.

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 percent effective in preventing pregnancy.

Natural family planning (fertility awareness)

This involves being aware of your menstrual cycle and when you ovulate to plan or avoid pregnancy. 

You can monitor when you ovulate, such as by measuring your temperature to see when it increases and being aware of vaginal discharge occurring around the 14th day of your menstrual cycle.   

If you’re interested in learning more about this method from a qualified fertility awareness teacher, you can find your local NHS fertility awareness clinic on FertilityUK’s website. 

Male and female condoms 

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

Oral contraceptive pills

There are two types of oral contraceptive pill, the combined pill containing the hormones oestrogen and progesterone, and the progesterone-only pill. They are small tablets you swallow every day. 

The combined contraceptive pill can slightly increase your blood pressure. Every time you go to your GP or practice nurse to get a repeat prescription, they will check your blood pressure before re-prescribing. 

There may also be an increased risk of deep vein thrombosis (DVT) - blood clots that occur in the lower leg. This then increases the risk of pulmonary embolism, where the blood clot travels in your bloodstream to the blood vessels going to 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 already have high blood pressure, then types of contraception that contain oestrogen are much less likely 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

The implant is effective for 3 years, but you can have it removed at any point before then if you’re experiencing side effects or you want to get pregnant. Your natural fertility will return very soon after having it removed.

If you have a heart condition it’s important you speak to your GP before having the implant inserted.

IUD (Intra-uterine device) and IUS (Intra-uterine system)

These are small ‘T’ shaped devices that are inserted into the uterus, which are often referred to as the ‘coil’. An IUD releases copper into your body and an IUS releases progestogen. To decide which is best for you, speak to your healthcare professional. 

For some women with heart conditions, you may be advised to have an IUD or IUS implanted within a hospital environment so you can be closely monitored.

Insertion of an IUD or IUS carries a risk of infection. Your doctor may recommend a course of antibiotics after having this procedure to reduce the risk.

Morning after pill

The morning after pill, sometimes called emergency contraception, is available from pharmacies. 

There are two types of morning after pill, EllaOne and Levonelle. EllaOne has to be taken within five days of unprotected sex to prevent pregnancy, and Levonelle has to be taken within three. The morning after pill won’t protect you against STIs. 

It’s important to note that you will have to pay for the morning after pill if getting it from a chemist. 

The morning after pill is not known to affect the heart so is thought to be safe for most women with a heart condition, but ensure you inform the pharmacist to be on the safe side. 

You should not rely on the morning after pill as a regular method of contraception, it is for emergency use only.

Sterilisation

Sterilisation is a permanent method of contraception and is a surgical procedure. 

The sterilisation procedure is sometimes performed under general anaesthetic which may be a risk if you have been diagnosed with a heart condition. You will need to check options with your doctor before undergoing 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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