CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Contraception - Management
How does the presence of hypertension influence choice?
- Women with hypertension that is adequately controlled
- Methods that can be used without restriction: progestogen-only pill, progestogen-only implants, copper intrauterine devices (IUDs), levonorgestrel-releasing intrauterine system (IUS), barrier methods, and natural family planning.
- Methods that can generally be used (advantages generally outweigh risks): progestogen-only injectables.
- Sterilization can be used with caution (extra preparation, precautions and counselling), with blood pressure controlled before surgery.
- Methods that are not usually recommended (risks usually outweigh the advantages): combined oral contraceptives (COCs), the combined contraceptive patch, and combined contraceptive vaginal ring.
- Women with consistently increased systolic blood pressure of more than 140 mmHg and less than 160 mmHg, or diastolic blood pressure more than 90 mmHg and less than 95 mmHg, without vascular disease:
- Methods that can be used without restriction: progestogen-only pill, progestogen-only injectables and implants, copper intrauterine devices (IUDs), levonorgestrel-releasing intrauterine system (IUS), barrier methods, and natural family planning.
- Sterilization can be used with caution (extra preparation, precautions and counselling), with blood pressure controlled before surgery.
- Methods that are not usually recommended (risks usually outweigh the advantages): combined oral contraceptives (COCs), the combined contraceptive patch, and combined contraceptive vaginal ring.
- Women with consistently increased systolic blood pressure 160 mmHg or more, or diastolic blood pressure 95 mmHg or more, without vascular disease
- Methods that can be used without restriction: progestogen-only pill, progestogen-only implants, copper IUDs, levonorgestrel-releasing IUS, barrier methods, and natural family planning.
- Methods that can generally be used (advantages generally outweigh the risks): progestogen-only injectables.
- Sterilization can be used but should be done in a setting with experienced healthcare professionals and medical support. Blood pressure should be controlled before surgery.
- Methods that should not be used (because of unacceptable risk): COCs, the combined contraceptive patch, and combined contraceptive vaginal ring.
- Women with hypertension and vascular disease
- Methods that can be used without restriction: copper IUDs, barrier methods, and natural family planning.
- Methods that can generally be used (advantages generally outweigh the risks): progestogen-only pill, progestogen-only implants, and the levonorgestrel-releasing IUS.
- Sterilization can be used but should be done in a setting with experienced healthcare professionals and medical support. Blood pressure should be controlled before surgery.
- Methods that are not usually recommended (risks usually outweigh the advantages): progestogen-only injectables.
- Methods that should not be used (because of unacceptable risk): COCs, the combined contraceptive patch, and combined contraceptive vaginal ring.
Basis for recommendation
- These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Health Care (FSRHC), formerly the Faculty of Family Planning and Reproductive Health Care (FFPRHC) [FSRH, 2009b].
© NHS Institute for Innovation and Improvement