Contraception, Hormone Replacement Therapy (HRT) and menopause
Concerns about the use of contraception and hormone replacement therapy by SCAD patients are based on the assumption that there is an association between SCAD and female sex hormones, however it is still unclear what this association is. At present there is no definitive evidence that hormonal contraception or HRT increase the risk of SCAD recurrence.
SCAD experts advise that it would be reasonable to avoid hormonal contraception where possible. In patients with recurrent cyclical chest pain, low-dose local hormone delivery via IUD (typically the Mirena Coil) has been anecdotally reported to be useful.
Beat SCAD Conference 2023
Systemic HRT is a balance of risks in all women. For SCAD patients if the menopause can be managed without HRT, this is the best and easiest option. If menopausal issues are mainly local, topically applied oestrogen (eg vaginally) may assist. For women with intrusive systemic menopausal symptoms, low-dose HRT options may be appropriate and is not contraindicated in SCAD. SCAD experts prefer the body-identical forms of HRT (patches and gels) rather than synthetic ones because they have a lower cardiovascular risk profile.
As with all medication, contraception and HRT is a very individual matter that must take into consideration all pre-existing health factors. It should be discussed with either your GP or cardiologist. You may also wish to seek a referral to a UK SCAD specialist to discuss your requirements further.
Click on the Resources below to listen to Dr David Adlam, SCAD expert, discuss contraception and HRT.
Resources
Beat SCAD Conference 2023 (starts at 31 mins)
Research update 2021 (starts at 35 mins)
Beat SCAD Walk 2022 (starts at 1 hour 3 mins)
Beat SCAD Conference 2018 (starts at 36 minutes)
FAQs
Concerns about the use of contraception by SCAD patients are based on the assumption that there is an association between SCAD and female sex hormones, however it is still unclear what this association is. At present there is no definitive evidence that hormonal contraception increases the risk of SCAD recurrence.
SCAD experts advise that it would be reasonable to avoid hormonal contraception where possible. In patients with recurrent cyclical chest pain, low-dose local hormone delivery via IUD (typically the Mirena Coil) has been anecdotally reported to be useful.
Watch Dr David Adlam, who is leading the UK SCAD research, discuss contraception after SCAD (starting at 31 minutes)
Concerns about the use of hormone replacement therapy by SCAD patients are based on the assumption that there is an association between SCAD and female sex hormones, however it is still unclear what this association is. At present there is no definitive evidence that HRT increases the risk of SCAD recurrence.
Systemic HRT is a balance of risks in all women. For SCAD patients if the menopause can be managed without HRT, this is the best and easiest option. If menopausal issues are mainly local, topically applied oestrogen (eg vaginally) may assist. For women with intrusive systemic menopausal symptoms, low-dose HRT options may be appropriate and is not contraindicated in SCAD.
As with all medication, contraception and HRT is a very individual matter that must take into consideration all pre-existing health factors. It should be discussed with either your GP or cardiologist. You may also wish to seek a referral to a UK SCAD specialist to discuss your requirements further.
Watch Dr David Adlam, who is leading the UK SCAD research, discuss HRT after SCAD (starting at 31 minutes).
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