Birth Control Pills and High Blood Pressure

The pill is the number one birth control method used by women ages 15 to 44. Four of every five sexually experienced women have used the birth control pill—26% of women in this age group also have high blood pressure. Is there any connection between the pill and high blood pressure?

Contraceptive pill
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How Birth Control Pills Affect Risk

Birth control pills contain synthetic hormones. Combination birth control pills are made from estrogen and progestin. The mini-pill is a progestin-only contraceptive. These hormones are the reason that the pill works to prevent pregnancy—but unfortunately, they can also increase your risk for high blood pressure.

If you use the pill and are older than 35, obese, and/or smoke, you may be at even more risk. Birth control pills can increase your blood pressure from slightly to potentially dangerous.

When using the pill, you may also have a slight increase in the risk of developing a blood clot. Sometimes, if your blood pressure becomes too high while using the pill, you may need to switch to a new birth control method.

High Blood Pressure Risk Factors

The risk of high blood pressure increases with your age. When women stop taking the pill, their blood pressure usually becomes lower. But some research says that birth control pills may cause a small (yet significant) increase in diastolic pressure—and this can continue in older women who have been off the pill for years.

The actual risk of developing high blood pressure while using birth control pills is not known. It is thought that the estrogen in the pill may trigger the release of other hormones that can cause your blood pressure to rise. Progestin has also been found to affect blood pressure—but it does not seem to increase blood pressure to the same degree that estrogen does.

There are some risk factors that may also make it more likely that birth control pill use will increase your blood pressure. These risk factors include:

  • A history of high blood pressure when you were pregnant
  • A family history of high blood pressure (especially in female relatives)
  • A history of heart problems or blood vessel issues

Is the Pill Contraindicated?

Before you start using the pill, your healthcare provider should conduct a thorough personal and family medical history (this should include paying attention to cardiovascular risk factors). It is very important that you are honest with your healthcare provider during this time. You should also have your blood pressure checked—this will establish a baseline measurement.

Once you begin to use the pill, you should have your blood pressure checked regularly. If your blood pressure begins to rise while you are using the pill, this does not automatically mean that you have to stop taking the pill. If your blood pressure can be successfully managed (either through diet and exercise or medication), your healthcare provider will most likely allow you to continue your pill use.

If you develop high blood pressure after starting the pill, your healthcare provider may decide to just monitor your blood pressure more frequently at first to see if it becomes an issue.

Based on your symptoms (if you have any), other risk factors, and the results of your blood pressure checks, your healthcare provider may:

  • Have you continue as normal and keep you on the same birth control pill.
  • Decide to change your prescription to a pill brand that contains a lower (or different type) or progestin or to a pill brand that does not contain any estrogen.
  • Have you stop using the pill and have you switch to a different birth control method.

If you are concerned about your pill use and high blood pressure, you can discuss the risks of staying on hormonal birth control with your healthcare provider. There is no rule that says you must continue to use the pill.

Birth Control for High Blood Pressure

If you decide that you want to stop taking the pill due to high blood pressure, there are other birth control methods that you can safely use:

  • Over-the-counter birth control: You can choose any over-the-counter method, including condoms, spermicide, sponge, and female condoms.
  • Prescription options: These include an IUD (like hormone-free ParaGard) or a diaphragm. Your healthcare provider may also be OK with you using a progestin-only method like Mirena IUD, Skyla IUD, Nexplanon, or Depo Provera.
  • Permanent methods: If you know that you are finished having children (or you do not want to have any kids), you can also safely look into permanent methods like tubal ligation.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Daniels K, Mosher WD. Contraceptive methods women have ever used: United States, 1982-2010. Natl Health Stat Report. 2013;(62):1-15.

  2. Oparil S. Hypertension and oral contraceptives. J Cardiovasc Med. 1981;6(4):381, 384-7.

  3. Kharbanda EO, Parker ED, Sinaiko AR, et al. Initiation of oral contraceptives and changes in blood pressure and body mass index in healthy adolescents. J Pediatr. 2014;165(5):1029-33. doi:10.1016/j.jpeds.2014.07.048

  4. Glisic M, Shahzad S, Tsoli S, et al. Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis. Eur J Prev Cardiol. 2018;25(10):1042-1052. doi:10.1177/2047487318774847

Additional Reading
  • Beevers, G., Lip, G., & O'Brien, E. (2010). ABC of hypertension (5th ed). Malden, MA: Blackwell Publishing.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.