A Literature Review on Contraceptive Methods for Women with Hypertension

Hypertension is one of the leading risk factors for cardiovascular disease and disproportionately affects women of reproductive age. Selecting a safe and effective contraceptive method for hypertensive women is critical to prevent complications. Estrogen-containing contraceptives may exacerbate blood pressure elevation and increase cardiovascular risk. This literature review aims to identify safe contraceptive methods for women with hypertension and summarize the current evidence to guide clinical decision-making. A systematic search was conducted in PubMed and ScienceDirect using keywords related to contraception, hypertension, and women. Inclusion criteria covered studies published between 2020– 2025 involving hypertensive women using hormonal or non-hormonal contraceptives, reporting blood pressure or cardiovascular outcomes. Following PRISMA guidelines, 20 studies were selected and synthesized narratively. Combined hormonal contraceptives (CHC) were associated with increased blood pressure and higher stroke risk (adjusted OR 1.44– 2.08). Progestin-only methods (POP, DMPA, implants) demonstrated no significant effect on blood pressure. Intrauterine devices (copper IUD and LNG-IUD) were the safest options, with no effect on blood pressure and high contraceptive efficacy. Contraceptive choices for women with hypertension should prioritize progestin-only and non-hormonal methods. CHC should be avoided in women with uncontrolled hypertension. Comprehensive counseling and routine blood pressure monitoring are essential to ensure safety and optimize reproductive health outcomes.