Hormonal Birth Control & Mental Health: PTSD Linked to Increased Cardiovascular Risk, Study finds
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A new study published in JAMA Network Open suggests a complex relationship between hormonal contraceptive use, stress-related psychiatric disorders, and cardiovascular health in women, with a notably concerning link for those with post-traumatic stress disorder (PTSD).
More than 400,000 women in the United States die annually from cardiovascular disease (CVD), the leading cause of death nationwide. Recognizing stress as a critically important CVD risk factor, and acknowledging the higher prevalence of stress-related conditions like anxiety and PTSD in women, researchers are increasingly focused on sex-specific factors influencing heart health.
This research, led by Jordan Thomas, PhD, of the University of Kansas, and with senior authorship from Antonia Seligowski, PhD, of the Neurocardiac Effects of Stress & Trauma Laboratory at Mass General Brigham, represents a crucial step forward in understanding these factors.”Past research has almost entirely focused on young, relatively healthy women,” a senior official stated, highlighting a critical gap in knowledge. “Very little is known about how hormonal contraceptives affect women already grappling with stress-related psychiatric disorders.”
Uncovering the Link Between Contraception, Stress, and Heart Health
The study investigated whether using hormonal contraceptives – wich alter hormone levels and suppress natural estradiol and progesterone – is associated with cardiovascular and thrombotic risk in women with and without a history of stress-related disorders.Researchers specifically examined the risk of major adverse cardiovascular events (MACE) and deep-vein thrombosis.
To conduct this research, the team analyzed healthcare records from 31,824 women participating in the Mass General Brigham Biobank, utilizing medical codes to identify diagnoses of stress-related disorders, MACE, deep-vein thrombosis, and prescriptions for hormonal contraceptives.
Protective Effects for Most, But a Warning for Those with PTSD
The findings revealed a nuanced picture. For the majority of women, including those with a history of anxiety or depression, hormonal contraceptive use was associated with a lower risk of MACE. Though, this protective effect was not observed in women with PTSD.
“These preliminary findings suggest that cardiovascular risk may vary among women who use hormonal contraceptives, especially differing for those with PTSD,” researchers noted. This indicates that the impact of hormonal birth control on heart health isn’t uniform and can be considerably influenced by a woman’s mental health history.
Future Research to Refine recommendations
researchers are planning a follow-up clinical study to gather more detailed data on the relationship between specific hormonal contraceptive formulas and CVD risk factors in women. This future research will assess factors like blood pressure, vascular endothelial function, and blood-based clotting markers. They also intend to investigate whether these effects differ based on the presence of stress-related psychiatric disorders, with participants returning annually for follow-up visits to track clinical outcomes.
If these results are confirmed, clinicians may need to carefully consider a patient’s history of stress-related psychiatric disorders – particularly PTSD – when discussing hormonal contraceptive options. This study underscores the importance of personalized medicine an
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