A large Danish study published in The BMJ found an elevated risk of ischaemic stroke and heart attack in women using certain hormonal contraceptives, based on national prescription data from 1996 to 2021.
The highest risk was observed in contraceptives containing estrogen, including the vaginal ring and transdermal patch. According to the study authors,
Analysis of data from over two million women aged 15–49 years revealed that combined estrogen-progestin pills double the risk of stroke and heart attack, leading to an estimated 4,760 additional stroke cases annually. Non-oral combined contraceptives present an even greater danger: the vaginal ring increases the risk of stroke by 2.4 times and heart attack by 3.8 times, while the skin patch raises stroke risk by 3.4 times.
Progestin-only contraceptives, such as pills and implants, also increase cardiovascular risk, though to a lesser extent. The only hormonal contraceptive not associated with elevated cardiovascular risk is the progestin-only intrauterine system, making it a potentially safer alternative for some women.
Despite the study’s observational nature, researchers emphasize the reliability of findings due to high-quality registry data. They call for thorough patient counselling on potential risks and advocate for further research to develop safer contraceptive options, particularly for women with existing cardiovascular risk factors.
This article is for informational purposes only and should not replace professional medical advice.
