Birth Control for People with High Blood Pressure

If you have high blood pressure or other risk factors for cardiovascular disease, your doctor may encourage you to avoid combination hormonal birth control and the birth control injection. But there are other birth control methods that may be safer for you.

High blood pressure raises your risk of cardiovascular disease, including heart attack and stroke.

Combination hormonal birth control methods that contain both estrogen and progestin may increase your blood pressure, which adds to your cardiovascular risk.

The birth control injection (Depo-Provera) may increase your cholesterol levels, which also increases cardiovascular risk.

If you have normal blood pressure levels, normal cholesterol levels, and good overall health, a small increase in blood pressure or cholesterol levels is unlikely to harm you.

But if you have high blood pressure, high cholesterol, or other risk factors for cardiovascular disease, your doctor might encourage you to avoid combination hormonal birth control methods and the birth control injection.

A healthcare professional can help you weigh the potential benefits and risks of these birth control methods and learn about other forms of birth control that may be safer for you.

If you have high blood pressure and you want to avoid pregnancy, your doctor may encourage you to use one or more of the birth control methods below.

Progestin-only birth control methods don’t appear to substantially affect blood pressure or cholesterol levels, but they may still carry certain risks. Your doctor can help you weigh the potential benefits and risks of different birth control methods.

Intrauterine device (IUD)

An IUD is a small T-shaped device that a healthcare professional inserts into your uterus to provide long lasting, reversible protection against unintentional pregnancy.

There are two main types of IUD:

• Hormonal IUDs: These release the hormone progestin, which helps prevents ovulation and thickens mucus in your cervix. Brands include Mirena, Kyleena, Liletta, and Skyla.
• Copper IUDs: These don’t contain hormones but are made of copper, which is toxic to sperm and eggs. The brand of copper IUD is Paragard.

Both types of IUD are more than 99% effective at preventing pregnancy.

If you get an IUD, your doctor will need to remove or replace it every 3–12 years depending on the specific type you get. They can remove the IUD at any point if you want to try to get pregnant.

IUDs don’t protect against sexually transmitted infections (STIs).

According to the Centers for Disease Control and Prevention (CDC) , hormonal IUDs are generally considered safe for individuals with high blood pressure since they only contain progestin.

Still, if you’re considering a hormonal IUD and have high blood pressure, it’s a good idea to discuss the risks versus benefits with your doctor.

Since the copper IUD doesn’t contain hormones, it doesn’t impact blood pressure.

Birth control implant

A birth control implant (Nexplanon) is a small rod that a healthcare professional inserts under the skin of your arm.

It releases progestin, which helps prevent ovulation and thickens mucus in your cervix to lower your chance of pregnancy.

The implant is a long-acting, reversible form of birth control that’s more than 99% effective at preventing pregnancy. It needs to be removed or replaced every 5 years.

The implant doesn’t protect against STIs.

According to the CDC , implants are generally considered safe for individuals with high blood pressure since they only contain progestin.

Still, if you’re considering an implant and have high blood pressure, it’s a good idea to discuss the risks versus benefits with your doctor.

Progestin-only birth control pills

Some types of birth control pill contain only one type of hormone: progestin. Progestin-only birth control pills are also known as “minipills.”

Progestin-only birth control pills don’t appear to increase blood pressure. They’re considered generally safe for people with high blood pressure and other risk factors for cardiovascular disease.

With typical use, birth control pills are 93% effective at preventing pregnancy.

Birth control pills don’t protect against STIs.

Barrier methods

Barrier methods of birth control physically block sperm or prevent it from entering your uterus. Since they don’t contain hormones, they don’t impact your blood pressure.

• Condoms: 87% effective at preventing pregnancy with typical use
• Internal condoms: 79% effective at preventing pregnancy with typical use
• Diaphragm with spermicide: 87% effective at preventing pregnancy with typical use
• Cervical cap with spermicide: 71–87% effective at preventing pregnancy with typical use
• Birth control sponge: 78–86% effective at preventing pregnancy with typical use

Using a condom or internal condom during sex also lowers your chance of getting STIs.

Diaphragms, cervical caps, and birth control sponges don’t protect against STIs.

Sterilization

If you never want to get pregnant, your doctor may recommend sterilization for you or your partner. Sterilization is a surgical procedure that provides permanent protection against pregnancy.

There are three main types of sterilization:

• Tubal ligation: This is an option for people who were assigned female at birth. In this procedure, a doctor surgically closes, cuts, or removes pieces of the fallopian tubes, which connect the ovaries to the uterus.
• Bilateral salpingectomy: This is another option for people who were assigned female at birth. In this procedure, a doctor removes the fallopian tubes entirely.
• Vasectomy: This is an option for people who were assigned male at birth. A doctor blocks or cuts the vas deferens, which are tubes that carry semen from the testicles.

All three types of sterilization are more than 99% effective at preventing pregnancy.

None of them protects against STIs.

High blood pressure may increase the risk of surgical procedures, including sterilization. Your doctor can help you understand the risks.

Other methods of birth control

Other methods of birth control that don’t impact blood pressure include:

• Fertility awareness methods: You track your ovulation and avoid sex or use another birth control method on days when you’re fertile.
• Pull-out method: Your partner removes their penis from your vagina before ejaculating.
• Outercourse: You avoid penis-in-vagina sex but take part in other sexual activities.
• Abstinence: You avoid sex entirely.

Fertility awareness methods are about 77–98% effective at preventing pregnancy, depending on which specific method or combination of methods you use to track ovulation.

The pull-out method is roughly 78% effective at preventing pregnancy.

Outercourse and abstinence are both 100% effective at preventing pregnancy if practiced consistently.

Abstinence also protects against STIs.