The pill can increase your risk of a heart attack.
Drospirenone may significantly increase potassium levels.
Pill-induced ventricular arrhythmias.
Let me rephrase that. The pill can cause heart problems which can make you at risk for cardiac arrest.
Your hormones regulate your QTc.
A prolonged heart rate–corrected QT interval (QTc) on an electrocardiogram (ECG) is a marker of an increased risk of Torsades de Pointes (TdP).
TdP is when your lower heart chambers beat faster and out of sync with the top half of your heart. This is a heart arrhythmia. You start feeling light-headed and faint. In serious TdP, it can cause cardiac arrest.
Joe-Elie Salem, MD, Ph.D., of Hôpital Pitié-Salpêtrière in Paris, and colleagues conducted a study from 2008 -2012 in 498 healthy, non-menopausal women. Oral contraceptive pills amplified Sotalol-induced QT interval prolongation with antiandrogenic properties. The strongest effect was observed in women taking drospirenone (as opposed to levonorgestrel).
Electrolyte disorders cause tdP.
The birth control pills Yaz, Yasmin, and Ocella, may significantly affect a woman's potassium levels than other birth control pills. Yaz and Yasmin contain the progestin drospirenone.
Drospirenone may significantly increase potassium levels.
"A significant reduction in Na+ and Cl- concentration. While significantly increasing potassium and bicarbonate concentrations compared with the control group."
Dr. Salem's study is the FIRST LONG TERM study. (We know that the controversy comes from comparing long-term vs. short-term 6-month use.)
It found QTc prolongation as a result of an IKr blocker in COC users vs. healthy volunteers.
How does the pill impact prolong QTc?
QTc prolongation of 50 milliseconds or longer compared with women taking either no OC or levonorgestrel.
QTc prolongation was higher 3 hours after exposure to sotalol in those taking drospirenone. (Mean increase 31.2 milliseconds from baseline versus 24.6 milliseconds). Compared with women who were not on any oral contraceptives.
This shows the impact of androgenic potency of the progestin taken—Drospirenone versus women on levonorgestrel (31.2 milliseconds vs. 24.2 milliseconds, P=0.005).
Women who have any form of heart disease should not take hormone-based birth control methods without consulting their physician.
One study reported that nearly 35% of 49 women had not been advised on the use of contraceptives. Counseling in another 30% had been inappropriate.
Another study reported the widespread use of OC formulations (33%), despite their association with an increased risk of thromboembolic disease.
EVEN THE WHO/CDC lists that when atrial flutter or fibrillation is present, either paroxysmal or permanent, caution in using combined hormonal contraceptives is advised because of the elevated risk thromboembolism.
Estrogen in birth control pills, patches, implants, rings, and injections can cause blood to clot easier, which can cause a heart attack if the clot blocks blood flow to the heart or can cause a stroke if the clot blocks blood flow to the brain.
Heart attack risk for women on OC's show a 50% increase - 80%.
Birth control pills can increase women's blood pressure.
If you are worried about heart disease, please consult your doctor. Family planning should not come at the sacrifice of other health issues.
Resources:
Salem J, Dureau P, Bachelot A, et al. Association of Oral Contraceptives With Drug-Induced QT Interval Prolongation in Healthy Nonmenopausal Women. JAMA Cardiol. 2018;3(9):877–882. doi:10.1001/jamacardio.2018.2251
Jolien W. Roos-Hesselink, Jerome Cornette, Karen Sliwa, Petronella G. Pieper, Gretchen R. Veldtman, Mark R. Johnson, Contraception and cardiovascular disease, European Heart Journal, Volume 36, Issue 27, 14 July 2015, Pages 1728–1734, https://doi.org/10.1093/eurheartj/ehv141
Saheed Khan, Yvo M. Smulders, Johanna I. P. de Vries, Angélique M. E. Spoelstra-de Man, "Life-Threatening Complications of Hormonal Contraceptives: A Case History," Case Reports in Obstetrics and Gynecology, vol. 2013, Article ID 186230, 3 pages, 2013. https://doi.org/10.1155/2013/186230