Exploring the relationship between hormonal contraception and hypertension risk in women of childbearing age in Indonesia
Behind the benefits of the Family Planning program in regulating pregnancy spacing, there is a health concern that every woman of childbearing age needs to know: the relationship between hormonal contraceptive pills and increased risk of hypertension. Along with the dominance of hormonal contraception as the main choice—with 51.8% of women of childbearing age in Indonesia using it according to Basic Health Research (Riskesdas) 2013—understanding the long-term health impacts becomes increasingly important 1 .
51.8%
of women of childbearing age in Indonesia use hormonal contraception
18.58%
of women of childbearing age in Tomohon use contraceptive pills
73.2%
of women of childbearing age in Taratara suffer from hypertension
In North Sulawesi, especially Tomohon City, this issue cannot be taken lightly. Data shows that 18.58% of women of childbearing age in Tomohon are users of contraceptive pills, while the prevalence of hypertension in the area continues to increase year by year 1 . A study at the Taratara Health Center, West Tomohon, revealed a worrying finding: 73.2% of women of childbearing age in the area suffer from hypertension, with most of them being users of hormonal contraceptive pills 1 . This article will thoroughly examine the relationship between these two health phenomena, focusing on the results of recent research and their implications for public health policy.
Hormonal contraceptive pills work by containing a combination of estrogen and progestin hormones or progestin alone. These synthetic hormones mimic the work of natural female hormones to prevent ovulation and pregnancy. However, this same mechanism also affects the cardiovascular system, especially blood pressure.
Estrogen in contraceptive pills is known to stimulate the renin-angiotensin-aldosterone system—a system that regulates fluid balance and blood pressure. When this system is overactive, blood vessels constrict and the body retains more water and sodium, which ultimately significantly increases blood pressure 3 .
This risk increases with the duration of use, where the accumulation of hormone exposure over time加重 the impact on the cardiovascular system 1 . This theory is supported by the World Health Organization (WHO) classification which places hormonal contraception as a risk factor for hypertension.
Research at the Pal III Pontianak Health Center found that 32.25% of hormonal contraceptive users experienced hypertension, with the percentage of hypertension incidence in pill and injection users equally high, at 50% for each method 3 .
An innovative study conducted in the working area of the Taratara Health Center, West Tomohon District, successfully revealed a real relationship between hormonal contraceptive pills and the incidence of hypertension in women of childbearing age. This research was designed as a descriptive study with a cross-sectional approach, which allows researchers to observe variable relationships at a certain point in time 1 .
This study involved 71 women of childbearing age as respondents, with sampling technique using random sampling to ensure good representation of the population. The number of samples was calculated using the Lemeshow formula, a reliable statistical method for public health research 1 .
The collected data were analyzed using univariate analysis, a statistical technique that aims to explain or describe the characteristics of each research variable separately. This analysis includes respondent characteristics, patterns of hormonal contraceptive pill use, and hypertension incidence 1 .
The research team used various instruments to ensure data accuracy:
The research results revealed significant findings related to the use of hormonal contraception and the incidence of hypertension. The data is presented in the following charts:
The chart above shows that hormonal contraceptive pills are the main choice for women of childbearing age in the research area, with usage reaching more than 70% 1 .
Data reveals a worrying health burden, where nearly three-quarters of women of childbearing age in the area suffer from hypertension 1 .
The success of a study depends heavily on the accuracy in selecting and using tools and methods. The following is the "scientist's toolbox" used in this research:
| Tool/Instrument | Function and Use |
|---|---|
| Mercury sphygmomanometer | Measuring blood pressure with high accuracy based on mercury column |
| Stethoscope | Listening to heart sounds and blood flow (Korotkoff sounds) during blood pressure measurement |
| Structured questionnaire | Collecting data on contraceptive history, respondent characteristics, and risk factors |
| Medical records | Tracking health history, previous diagnoses, and patterns of health service use |
| Lemeshow formula | Statistical method for calculating sample size when population is not known for certain |
| Univariate analysis | Statistical technique to describe the characteristics of each research variable |
The findings of this study have important implications for clinical practice and public health policy. Regular blood pressure monitoring should be an integral part of family planning services, especially for users of hormonal contraception 3 .
Based on WHO classification, some acceptors of hormonal contraception were found not to comply with established recommendations, which opens room for improvement in screening and selection of contraceptive methods 3 .
At the individual level, women of childbearing age need to be empowered with adequate knowledge about the potential side effects of hormonal contraception, so they can be actively involved in decision-making about their reproductive health.
A comprehensive counseling approach should include not only information about the effectiveness of contraceptive methods, but also potential impacts on cardiovascular health in the long term.
Health workers need to pay attention to factors such as hypertension history, age, and duration of contraceptive use when recommending certain methods.
The use of hormonal contraceptive pills does have an important contribution to the Family Planning program, but research evidence shows a significant correlation with increased incidence of hypertension in women of childbearing age.
The findings in Taratara Health Center, where 70.4% of women of childbearing age use hormonal contraceptive pills and 73.2% suffer from hypertension, underline the urgency of a more cautious approach in family planning services 1 .
Regular blood pressure monitoring, selection of contraceptive methods tailored to individual health conditions, and comprehensive health education become important pillars in balancing the benefits of contraception and potential health risks. Thus, birth control efforts should not sacrifice the cardiovascular health of Indonesian women.
This article is compiled based on reliable research results published in scientific journals. For personal health consultation, it is recommended to consult directly with health workers.