The INFO Project Blog

The news media is touting a new study linking longterm oral contraceptive use with arterial plaque build-up as “troubling” and “concerning.” Click on the video still above to see MSNBC’s fever-pitch report.

Among 1,301 women ages 35-55 in Belgium, researchers found that, on average, users of oral contraception (”the Pill”) had a 20%-30% increase in arterial plaque for every decade of use. The main concern is that, as plaque builds up over time, the arteries harden and narrow (a condition called atherosclerosis), increasing the risk for heart attack and stroke.

What do these findings mean for women using the Pill? At the moment, women do not need to  change their oral contraceptive regimen but can discuss their concerns with their doctor. For the following reasons, more research needs to be done before doctors can change recommendations based on the new evidence.

• The study is observational, not a rigorous clinical trial. It does not prove that oral contraceptives cause arterial hardening, only that there is an association.
• Past research on oral contraceptive use and heart disease has been inconclusive and the association continues to be debated. More research is needed to confirm or refute the recent findings.
• The findings may not apply to today’s lower-dose oral contraceptives. Low-dose pills contain one-fourth or less estrogen and substantially less progestin than early pill formulations.

The findings should not trigger alarms about the safety of the pill, according to the lead researcher of the study, Dr. Rietzschel: “Bottom line: don’t discontinue your pill suddenly. Don’t panic. Don’t call your gynecologist tomorrow morning.”

Instead, Rietzschel recommends women “think about your other risk factors [for cardiovascular disease].” Older age, smoking diabetes, and high blood pressure are the primary risk factors for arterial heart disease. According to Rietzschel, women who smoke or have a strong family history of heart disease may want to avoid oral contraception.

To learn more about oral contraceptives, see this evidence-based guide for family planning providers.

Posted by Vidya Setty, writer for Population Reports