Key result
Hormonal contraceptives lack consistent cardiometabolic risk but modestly raise BP and triglycerides in high-risk women.
Why the study?
Safety of hormonal contraceptives in women with cardiometabolic disorders remains a key concern, requiring updated evidence for risk-stratified decision-making as these conditions increase globally.
Does hormonal contraceptive use affect cardiometabolic, glycaemic, and metabolic safety in women with underlying medical conditions?
Systematic Review
Does hormonal contraceptive use affect cardiometabolic, glycaemic, and metabolic safety in women with underlying medical conditions?
Hormonal contraceptive use shows no consistent short-term cardiometabolic risk in women with medical conditions, though modest adverse changes in high-risk populations warrant risk-stratified use.
Answers are grounded in this paper and cite their sources.
Supports risk-stratified use in high-risk women; extends short-term cardiometabolic safety evidence.
Background: Hormonal contraceptives are widely used, however, their safety among women with underlying medical conditions, particularly cardiometabolic disorders such as hypertension, diabetes mellitus, and obesity, remains a key clinical concern. As the prevalence of these conditions increases globally among women of reproductive age, updated evidence is required to support risk-stratified contraceptive decision-making. Objective: To evaluate the cardiometabolic, glycaemic, and metabolic safety of hormonal contraceptive use among women with underlying medical conditions. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Web of Science, and Scopus were searched for English-language human studies published between 2015 and 2025. Eligible studies included randomized controlled trials, cohort studies, case–control studies, and comparative observational designs. Data were synthesized descriptively due to heterogeneity in study populations, exposure characteristics, and outcome measures. Methodological limitations included English-language restriction, lack of protocol registration, and inconsistent reporting of contraceptive dose, formulation, and duration. Results: A total of 44 studies were included, with combined estrogen-containing contraceptives being the most frequently evaluated (79.5%, 35/44). Progestin-only methods 18.2% (8/44); long-acting reversible contraceptives 18.2% (8/44); mixed hormonal exposure 13.6% (6/44). Hypertension was the most commonly reported comorbidity, followed by diabetes mellitus and obesity. Lipid and metabolic parameters were reported in 31.8% (14/44) of studies, blood pressure outcomes in 25.0% (11/44), and glycaemic outcomes in 15.9% (7/44). No notable short-term changes were observed however, modest increases in systolic blood pressure, triglycerides, and insulin resistance were identified in selected high-risk populations. Conclusion: Hormonal contraceptive use shows no consistent short-term cardiometabolic risk; however, modest adverse changes in high-risk populations requires risk-stratified use and further standardized longitudinal research.
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Eze et al. (2026) conducted a systematic review in Cardiometabolic disorders (hypertension, diabetes mellitus, obesity). Hormonal contraceptives vs. Non-use of hormonal contraception or non-hormonal methods was evaluated on Cardiometabolic, glycaemic, and metabolic safety. Hormonal contraceptive use in women with medical conditions showed no consistent short-term cardiometabolic risk, but modest increases in systolic blood pressure, triglycerides, and insulin resistance were identified in high-risk populations.
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