Contraceptive Safety for Women with Hypertension

Introduction to Contraceptive Options

The American College of Obstetricians and Gynecologists recommends progestin-only contraceptives like Nexplanon as the first-line hormonal option for women with hypertension 1

Progestin-only contraceptives like Nexplanon are recommended as the first-line hormonal option for women with hypertension 1
Combined hormonal contraceptives are contraindicated in women with hypertension, even if well-controlled 1

Blood pressure should be checked at least every 6 months for women using any hormonal contraceptive method 1
Baseline cardiovascular risk assessment should be performed before initiating Nexplanon, including evaluation for additional risk factors (age >35 years, smoking, obesity, family history of hypertension) 1
Regular monitoring of blood pressure is essential, especially in women with pre-existing hypertension 1

For women approaching menopause (like this 44-year-old), progestin-only methods provide effective contraception without the cardiovascular risks associated with estrogen 1
Avoid prescribing combined hormonal contraceptives (pills, patches, rings) which contain estrogen, as these can increase blood pressure and cardiovascular risk 2, 1
Be aware that some antihypertensive medications may have interactions with hormonal contraceptives, though this is more common with combined methods than with progestin-only options 1