What are blood pressure and hypertension? 
Blood pressure is defined as the “measurement of the force against the walls of your arteries as your heart pumps blood through your body.” It is recorded as two numbers, often expressed like a fraction; i.e. 120/80. The top number is the systolic blood pressure, which is the force against the blood vessels as the heart contracts, and the top is the diastolic, or the force against the blood vessels while the heart is at rest. Normal blood pressure is about 120/80 or lower. High blood pressure, or hypertension, is when your blood pressure is at 140 on top or 90 on the bottom.
Hypertension can damage the walls of your arteries, putting you at risk for blood clots, which can in turn put you at risk for stroke. It also often has no symptoms unless it becomes very high, so you can be hypertensive and not be aware until you are seen for a visit with your doctor.
What does this have to do with my birth control?
Birth control containing estrogen can also cause blood clots, high blood pressure, and stroke. The combination of hypertension and birth control containing estrogen increases your risk of experiencing a negative side effect like a blood clot or stroke. Most health care providers will not prescribe birth control containing estrogen to women with hypertension.
What can I do?
Hypertension can be managed. Lifestyle changes such as a heart-healthy diet, exercise, quitting smoking, limiting alcohol and sodium, and weight loss can lower your blood pressure. A primary care provider may prescribe medication to help lower it if necessary.
Can I still have birth control?
If you are found to have high blood pressure, you are still able to get hormonal birth control as long as it does not contain estrogen. The primary difference someone might notice between birth control methods containing estrogen and methods not containing estrogen is period regulation. Combined hormonal methods like your common pill, the Nuva Ring, and the Patch will generally make your periods come once a month right on time. However, progestin-only methods like the Mirena IUD, “mini-pill”, and the Depo-shot can cause irregular spotting or no periods at all. When it comes to choosing a birth control method, what you will or won’t like has a lot to do with the convenience of the method and your individual body. Talk to your healthcare provider about what options might be right for you.
