Contraception Decision-making for Pre-menopausal Women with Cardiovascular Disease

Guest: Margaret Long, M.D.

Host: Marysia Tweet, M.D., M.S.

This podcast discusses how to approach contraceptive counseling for premenopausal women with cardiovascular disease, emphasizing individualized decision-making based on pregnancy goals and medical risks. It highlights safer options—such as progestin-only methods and intrauterine devices—while cautioning against estrogen-containing contraceptives due to increased thrombotic risk. The discussion also reviews practical considerations for cardiologists, including managing contraception after cardiac events and coordinating care with specialists. Overall, it underscores that effective contraception is typically safer than pregnancy for patients with significant cardiac conditions

Topics Discussed:

How do you approach contraception decision making in a patient with cardiac disease?
Are some contraception options safer than others? Are those options just as effective?
Will a specific method affect blood pressure or cholesterol? Are there other side effects to be aware of?
What if a patient has an adverse event such as a heart attack or pulmonary embolus while on oral contraception? What is your approach to those patients?
What are the most important lessons you would like to share with cardiovascular specialists?

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Podcast episode transcript found here.

Recorded on: 23-January-2026