I smoke – what contraception can I use?
If you smoke, you can use most types of contraception. But if you’re over 35 and you smoke, then methods that use combined hormones – like the pill, patch and ring – might not be suitable.
Combined contraceptives can slightly increase your chance of getting thrombosis or having a stroke or heart attack. Smoking and age also increase these risks. So when you combine smoking, age and combined contraception, the level of risk then outweighs the benefits.
If you’re aged over 35 and you smoke, you can look at these methods of contraception:
non-hormonal coil
contraceptive implant
These methods use only one hormone (a copy of progesterone) or no hormones at all, so will not increase your risk.
The risk of a heart attack
There are four things that can increase your risk of having a heart attack:
smoking
high blood pressure
high cholesterol
older age
Combined contraceptive methods also cause a slightly increased risk of heart attacks. Heart attacks are rare in people under 50 and the increased risk is very small.
Combined contraceptive methods contain both oestrogen and progestogen, and include the:
Smoking increases the risk of heart attacks because it causes the buildup of plaque, a waxy substance made of cholesterol, scar tissue, calcium and fat. This plaque appears on the inside of the arteries, the major blood vessels that carry blood from your heart to your body.
The buildup of plaque in your arteries is called atherosclerosis, and it increases with age.
Atherosclerosis narrows your arteries, and the combined methods of contraception increase the risk of thrombosis. These 2 things combined means there’s a higher risk to people over 35.
If you're concerned about the risks or want to find out more about which contraception methods might suit you, read through our contraception information or speak to your GP or sexual health clinic.
