Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis
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Aims: The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic review and meta-analysis to determine the impact of POC use on cardiometabolic outcomes including venous thromboembolism, myocardial infarction, stroke, hypertension and diabetes. Methods and results: Nineteen observational studies (seven cohort and 12 case–control) were included in this systematic review. Of those, nine studies reported the risk of venous thromboembolism, six reported the risk of myocardial infarction, six reported the risk of stroke, three reported the risk of hypertension and two studies reported the risk of developing diabetes with POC use. The pooled adjusted relative risks (RRs) for venous thromboembolism, myocardial infarction and stroke for oral POC users versus non-users based on the random effects model were 1.06 (95% confidence interval (CI) 0.70–1.62), 0.98 (95% CI 0.66–1.47) and 1.02 (95% CI 0.72–1.44), respectively. Stratified analysis by route of administration showed that injectable POC with a RR of 2.62 (95% CI 1.74–3.94), but not oral POCs (RR 1.06, 95% CI 0.7–1.62), was associated with an increased risk of venous thromboembolism. A decreased risk of venous thromboembolism in a subgroup of women using an intrauterine levonorgestrel device was observed with a RR of 0.53 (95% CI 0.32–0.89). No effect of POC use on blood pressure was found, but there was an indication for an increased risk of diabetes with injectable POCs, albeit non-significant. Conclusions: This systematic review and meta-analysis suggests that oral POC use is not associated with an increased risk of developing various cardiometabolic outcomes, whereas injectable POC use might increase the risk of venous thromboembolism.
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Current use of the progesterone only pill is not associated with risk of myocardial infarction or stroke.
“In contrast, no association was seen between current use of the progesterone only pill and risk of myocardial infarction or stroke.72”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [72]
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References 71 · Cited by 124
Research works printed but not linked: 1
- [63]Walsh JS Eastell R Peel NF Effects of depot medroxyprogesterone acetate on bone density and bone metabolism before and after peak bone mass: a case–control study. J Clin Endocrinol Metab 2008; 93: 1317– 1323. 18230659
- Authors
- Glisic, M., Shahzad, S., Tsoli, S., Chadni, M., Asllanaj, E., Rojas, L. Z., Brown, E., Chowdhury, R., Muka, T., & Franco, O. H.
- Affiliations
- Department of Epidemiology, Erasmus Medical Center, The Netherlands
- University of Cambridge (GB)
- London School of Hygiene & Tropical Medicine (GB)
- University of Oxford (GB)
- Erasmus MC (NL)
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-05-10
- Volume
- 25
- Issue
- 10
- Pages
- 1042-1052
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- PMC
- PMC6039863
- OpenAlex
- W2802527109
- Cited by
- 124
- References
- 71
- Citations by year
- 2026: 14 · 2025: 23 · 2024: 16 · 2023: 17 · 2022: 16 · 2021: 15 · 2020: 11 · 2019: 7 · 2018: 4 · 2017: 1
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Apollo
- Funders
- National Institute for Health and Care Research (NF-SI-0617-10113, NF-SI-0512-10165)
- British Heart Foundation (RG/13/13/30194)
- Medical Research Council (MR/L003120/1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- progestin-only contraceptives, cardiometabolic outcomes, venous thromboembolism, myocardial infarction, stroke, hypertension, diabetes mellitus, injectable contraceptives, oral contraceptives, levonorgestrel intrauterine device, route of administration
- MeSH terms
- Administration, Oral, Adolescent, Adult, Aged, Cardiovascular Diseases, Contraceptives, Oral, Hormonal, Diabetes Mellitus, Drug Implants, Female, Humans, Injections, Middle Aged, Progestins, Risk Factors, Risk Assessment, Venous Thromboembolism, Young Adult
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