For 27-year-old Payal (name changed), April once brought joy as a newlywed. But on June 2, a bout of severe acidity shattered those pleasant memories as it escalated into acute chest pain by midnight. By 2 a.m., her family rushed her to Saifee Hospital near Charni Road, where cardiologist Dr. Kaushal Chhatrapati confirmed she had suffered a heart attack.
Emergency Intervention Saves Her Life
Doctors detected abnormal changes in Payal’s ECG that indicated a heart attack. Dr. Chhatrapati immediately performed an angioplasty, inserting a stent into her circumflex artery in the early hours of June 3. The diagnosis shocked her family—Payal was young, otherwise healthy, and in her reproductive years, a phase when estrogen generally protects women from heart disease.
Contraceptive Pills Under Scrutiny
Dr. Chhatrapati identified the likely trigger—oral contraceptive pills prescribed for polycystic ovary syndrome (PCOS), a common hormonal disorder. Payal had taken these pills for seven years to manage PCOS symptoms such as irregular periods and ovarian cysts. Her father confirmed she had struggled with the condition for nearly a decade.
Research Links Hormonal Pills to Cardiovascular Risk
A recent study published in The BMJ by Danish researchers reinforces these concerns. It found that women using the combined estrogen-progestin pill faced double the risk of ischemic stroke and heart attack. Specifically, the data suggested one extra stroke per 4,760 women annually, and one extra heart attack per 10,000 women per year of use. The study also flagged estrogen-containing vaginal rings and patches as particularly risky.
Experts Urge Caution
As reported by TOI, Gynaecologist Dr. Kiran Coelho emphasized that strokes are more commonly linked to contraceptive pills than heart attacks. “I’ve treated 22- and 28-year-old women with PCOS who suffered strokes,” she said. Yet, she noted that hormonal pills remain necessary to suppress ovulation and reduce ovarian cyst formation.
Urban Stress and PCOS Connection
Dr. Coelho also warned of rising PCOS rates among urban Indian women, fueled by high stress levels, obesity, and insulin resistance. These underlying conditions often lead to dyslipidaemia, a buildup of harmful blood lipids that elevate heart disease risk. “One in five adolescent girls in urban India now suffers from PCOS,” she noted.
Family History Must Be Considered
Cardiologist Dr. Rajeev Bhagwat from Nanavati Hospital added that contraceptive pills are known to increase the risk of thrombosis (blood clots), which can lead to strokes or heart attacks. He stressed the importance of evaluating a woman’s family history of cardiovascular disease before prescribing hormonal pills. “Genetics play a strong role in young-onset heart disease,” he said.
The Takeaway
Payal’s case underscores the need for informed prescription practices and greater awareness among women about the potential cardiovascular risks of long-term hormonal contraceptive use, especially in the presence of conditions like PCOS. Doctors advise personalized risk assessments, regular monitoring, and lifestyle interventions as essential steps in managing women’s reproductive and heart health.