Contraception in women with cardiovascular risk factors

Peter Chedraui (EC)

[Chedraui] Institute of Biomedicine, Guayaquil

Contraceptive use and unmet need for family planning are key for the understanding of profound changes in fertility and the improvement of reproductive health worldwide. Contraceptives are currently being used by the majority of women in almost all regions of the world. In 2015, 64% of married or in-union women of reproductive age worldwide were using some form of contraception. However, contraceptive use was much lower in the least developed countries and Africa (30-40%). The selection of any type of contraceptive method requires a thorough evaluation of the patient’s needs, contraindications, side-effects, and in the case of hormonal ones their interactions with drugs and any potential risk they may cause. Due to changes in dietary and lifestyle factors, obesity is increasing worldwide. This situation enhances cardiovascular risk significantly, basically due to a higher prevalence of hypertension, diabetes and insulin resistance, issues intimately related to higher body weight. On the other hand, there is an increasing trend of more alcohol and tobacco consumption among younger women. All these factors require relevant assessment before choosing and appropriate contraceptive method, especially when considering methods with hormonal component. For these women, long-acting reversible contraceptives, such as intrauterine devices and the contraceptive implant should be considered. This presentation will aim at performing a general overview of contraceptive methods used during female childbearing years, their contraindications and aspects related their use in women with cardiovascular risk factors.