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Birth Control Pills, Hormone Therapy, and Coronary Artery Disease

Topic Overview

Women have unique risk factors for heart disease. These include pregnancy-related problems as well as medicines they may be taking, such as birth control pills or hormone therapy.

Birth control pills

Healthy, young, nonsmoking women probably do not increase their risk of coronary artery disease (CAD) when they take low-dose birth control pills (oral contraceptives).

But if a woman has other significant risk factors for CAD, taking birth control pills may further increase this risk. For instance, birth control pills are more likely to increase a woman's risk if she is older than 35 and smokes cigarettes. Birth control pills may raise "bad" cholesterol (low-density lipoprotein, or LDL) and lower "good" cholesterol (high-density lipoprotein, or HDL).

Hormone therapy

If you have menopausal symptoms such as hot flashes and vaginal dryness, you might consider hormone therapy (HT) to relieve your symptoms. Because menopause and hormones are linked with the health of your blood vessels, you and your doctor will discuss your health and your risk of heart disease to make sure hormone therapy is safe for you. Risk for heart disease and other health problems varies based on when you start HT in menopause and how long you take it. Short-term use of hormone therapy in early menopause has less risk than when it is started later in menopause. Risk also depends on the type of HT used (estrogen or estrogen plus progestin).1

Talk to your doctor about your risks with hormone therapy. And carefully weigh its benefits against the risks of taking it. If you need relief for symptoms of menopause, hormone therapy is one choice you can think about. But there are other types of treatment for problems like hot flashes and sleep problems.

References

Citations

  1. North American Menopause Society (2012). The 2012 hormone therapy position statement of the North American Menopause Society. Menopause, 19(3): 257–271. Also available online: http://www.menopause.org/PSht12.pdf.

Other Works Consulted

  • Charney P (2011). Women and coronary artery disease. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 2, pp. 2226–2240. New York: McGraw-Hill.
  • Mosca L, et al. (2011). Effectiveness-based guidelines for the prevention of cardiovascular disease in women 2011 update: A guideline from the American Heart Association. Circulation, 123(11): 1243–1262.
  • U.S. Preventive Services Task Force 2012. Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: U.S. Preventive Services Task Force Recommendation Statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf12/menohrt/menohrtfinalrs.pdf.

Credits

By Healthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Current as of April 9, 2014

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