Using hormonal birth control and smoking cigarettes presents a heightened risk to health. Understanding the potential health implications of this combination is important for individuals using contraception. These considerations can help guide informed decisions about personal well-being.
Understanding the Primary Health Risks
Smoking while using hormonal birth control significantly increases the risk of serious cardiovascular complications. These risks include deep vein thrombosis (DVT), pulmonary embolism (PE), heart attack, and stroke. The combination can raise the risk of cardiovascular disease by two to four times compared to smoking or using birth control alone.
Deep vein thrombosis involves a blood clot in a deep vein, often in the legs. This clot can dislodge and travel to the lungs, causing a pulmonary embolism, a life-threatening condition. Both smoking and hormonal contraceptives contribute to these clot formations.
Beyond blood clots, individuals face an elevated risk of heart attack and stroke. A heart attack occurs when blood flow to the heart is blocked, damaging the muscle. A stroke happens when blood flow to the brain is interrupted, causing brain damage. The combined effect of smoking and hormonal birth control can double, triple, or even quadruple these chances, even for women in their 20s.
How Smoking Affects Hormonal Contraception
Smoking introduces harmful chemicals, including nicotine, which negatively affect blood vessel health. These substances can make blood vessels hard and restricted, impeding blood flow. This damage can lead to plaque formation and atherosclerosis, where fatty deposits accumulate inside arteries, blocking blood flow and increasing cardiovascular events.
Hormonal contraception, particularly estrogen-containing methods, impacts the cardiovascular system. Estrogen can thicken the blood, promoting clot formation in the legs, lungs, and brain. Additionally, estrogen can raise blood pressure and alter blood lipid levels, such as decreasing HDL cholesterol and increasing LDL cholesterol and triglycerides.
When smoking is combined with estrogen-containing birth control, these individual effects are amplified. The restricted blood vessels from smoking, coupled with the blood-thickening effects of hormones, elevate the risk of blood clots, heart attacks, and strokes. This combination places additional stress on the cardiovascular system.
Individual Risk Factors
Several individual factors can compound the risks for those who smoke while using hormonal birth control. Age is a factor, with women over 35 facing an elevated risk of heart disease and stroke when combining smoking with hormonal contraceptives. The risk also increases with the number of cigarettes smoked daily.
Pre-existing health conditions also heighten vulnerability. Individuals with a family history of cardiovascular disease, including heart attacks or strokes, have an increased predisposition. Other conditions like obesity, high blood pressure (hypertension), and diabetes also contribute to a higher risk of cardiovascular complications.
For instance, obesity, when combined with oral contraceptive use, can increase the risk of venous thromboembolism by 12 to 24 times compared to non-obese non-users. High blood pressure and diabetes are independently linked to an increased risk of stroke and heart disease, and their presence alongside smoking and hormonal birth control intensifies these dangers. Migraines with aura are another factor that can increase stroke risk in combined hormonal contraceptive users who smoke.
Safer Contraceptive Options and Medical Consultation
Individuals who smoke and use hormonal birth control should consult a healthcare provider to discuss contraceptive options. This allows for evaluation of personal risk factors and determination of the safest method. Medical professionals can provide tailored recommendations based on an individual’s health profile and smoking status.
For smokers, especially those over 35, estrogen-containing birth control methods are generally not recommended due to increased cardiovascular risks. Alternatives that do not contain estrogen include progestin-only pills, which thicken cervical mucus and thin the uterine lining to prevent pregnancy.
Long-acting reversible contraceptives (LARCs) such as intrauterine devices (IUDs) and implants are highly effective and safe options for smokers. Both hormonal IUDs, which release progestin, and non-hormonal copper IUDs are suitable. Barrier methods like condoms offer protection against pregnancy and sexually transmitted infections without hormones, though their effectiveness depends on consistent use.